Thrush & Clark Allergists PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

11974 Issued in WV

Legal business name

THRUSH & CLARK ALLERGISTS PLLC

Practice address

3411A Noyes Avenue SE
Charleston, WV 25304

Phone

(304) 344-2459

Fax

(304) 345-1336

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

James P Clark II, MDNPI 1306838453

Title

Managing Physician

Phone

(304) 344-2459

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Paul Clark II, MD

  • Allergy & Immunology Physician
  • Charleston, WV
  • NPI 1306838453
  Medicare reassignment Care Compare group NPD Authorized official
• Lawrence Blair Thrush Jr., MD

  • Allergy & Immunology Physician
  • Charleston, WV
  • NPI 1356333405
  Medicare reassignment Care Compare group NPD
• Laurie R Jones, NURSE PRACTIONEER

  • Adult Health Nurse Practitioner
  • Charleston, WV
  • NPI 1073737714
  Medicare reassignment
• Sandra Jane Wotring, RN,MSN,FNP

  • Family Nurse Practitioner
  • Charleston, WV
  • NPI 1730330192
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1225118946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411A NOYES AVENUE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-344-2459",
            "fax_number": "304-345-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411A NOYES AVENUE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-344-2459",
            "fax_number": "304-345-1336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3977 Teays Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Hurricane",
            "state": "WV",
            "postal_code": "255269082",
            "country_code": "US",
            "telephone_number": "304-344-2459",
            "fax_number": "304-345-1336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THRUSH & CLARK ALLERGISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "304-344-2459",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "11974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810006069",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Thornton
• Paula Thornton
• Stephanne Cline Thornton, MAC, LCSW, LICSW
• Ted Thornton, MD
• Jan Thrash-Davidson
• Lawrence Blair Thrush Jr., MD
• Nicole Tibbs
• Amy E. Tickle, MD
• Tyler Tickle
• James P. Tierney, DO

• Specialist in Charleston, WV
• Providers in Charleston, WV by specialty
• Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.