NPIMap

Organization Active NPI

Sunshine Outpatient Clinic LLC

  • Clinic/Center
  • Beckley, WV
National Provider Identifier
1174282065
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SUNSHINE OUTPATIENT CLINIC LLC
Practice address
1769 Robert C Byrd Dr
Beckley, WV 25801-8707
Phone
(304) 222-2329
NPI assigned
Dec 8, 2021
Last updated
Jan 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donna Jean Evans, OTR/LNPI 1194887018
Title
Owner
Phone
(304) 222-2329

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1769 Robert C Byrd Dr
Beckley, WV 25801-8707

Mailing address

1701 Robert C Byrd Dr
Beckley, WV 25801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240112000472 WV Part B Supplier - Clinic/Group Practice 4688042849 Receives reassigned benefits from 4 practitioners
Practice locations: Beckley, WV

National Provider Directory

National Provider Directory

Locations

1701 Robert C Byrd Dr
Beckley, WV 25801

1769 Robert C Byrd Dr
Beckley, WV 25801
Phone (304) 222-2329

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1174282065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 ROBERT C BYRD DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "25801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1769 ROBERT C BYRD DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258018707",
            "telephone_number": "304-222-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE OUTPATIENT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-222-2329",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.