NPIMap

Organization Active NPI

Braxton VA Clinic

  • VA Clinic/Center
  • Gassaway, WV
National Provider Identifier
1194776823
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
BRAXTON VA CLINIC
Practice address
707 Elk St
Gassaway, WV 26624-1113
Phone
(304) 364-8941
Fax
(304) 364-8943
NPI assigned
May 15, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Barbara Mayerick
Title
Director, Business Development
Phone
(202) 254-0339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X Primary

Addresses

Primary practice location

707 Elk St
Gassaway, WV 26624-1113

Mailing address

707 Elk St
Gassaway, WV 26624-1113
Phone (304) 364-8941

National Provider Directory

National Provider Directory
Tax ID family
Beckley Vamc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

707 Elk St
Gassaway, WV 26624
Phone (304) 364-5200

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194776823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 ELK ST",
            "city": "GASSAWAY",
            "state": "WV",
            "postal_code": "266241113",
            "telephone_number": "304-364-8941",
            "fax_number": "304-364-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 ELK ST",
            "city": "GASSAWAY",
            "state": "WV",
            "postal_code": "266241113",
            "telephone_number": "304-364-8941",
            "fax_number": "304-364-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAXTON VA CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAYERICK",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "DIRECTOR, BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "202-254-0339"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gassaway, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.