Active NPI
Tygart Valley Medical Specialties, Inc
- Multi-Specialty Clinic/Center
- Elkins, WV
National Provider Identifier
1235596677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- License
- 21597
- Legal business name
- TYGART VALLEY MEDICAL SPECIALTIES, INC
- Practice address
- 911 Gorman Ave Ste 201
Elkins, WV 26241-3154 - Phone
- (304) 637-6302
- Fax
- (304) 637-6307
- NPI assigned
- Jan 15, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandy Young
- Title
- Front Office/ Billing Manager
- Phone
- (304) 637-6302
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | 21597 | WV | Primary |
Addresses
Primary practice location
911 Gorman Ave Ste 201
Elkins, WV 26241-3154
Mailing address
911 Gorman Ave Ste 201
Elkins, WV 26241-3154
Phone (304) 637-6302
Other names 1
- MedCorp-Tygart Valley Medical Specialties
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D1070912 | Tygart Valley Medical Specialties, Inc | Certificate of waiver | Jul 11, 2027 |
National Provider Directory
National Provider DirectoryLocations
911 Gorman Ave
Ste 201
Elkins, WV 26241
Phone (304) 637-5426
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Otolaryngology Physician
- Elkins, WV
- NPI 1487858775
-
- Family Nurse Practitioner
- Elkins, WV
- NPI 1942955570
-
- Family Nurse Practitioner
- Elkins, WV
- NPI 1003318841
-
- Medical Physician Assistant
- Belington, WV
- NPI 1174550958
-
- Nurse Practitioner
- Petersburg, WV
- NPI 1376118232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452816000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758499200000",
"number": "1235596677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 GORMAN AVE STE 201",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413154",
"telephone_number": "304-637-6302",
"fax_number": "304-637-6307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 GORMAN AVE STE 201",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413154",
"telephone_number": "304-637-6302",
"fax_number": "304-637-6307"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TYGART VALLEY MEDICAL SPECIALTIES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-01-15",
"last_updated": "2025-09-22",
"certification_date": "2025-09-22",
"status": "A",
"authorized_official_last_name": "YOUNG",
"authorized_official_first_name": "SANDY",
"authorized_official_title_or_position": "FRONT OFFICE/ BILLING MANAGER",
"authorized_official_telephone_number": "304-637-6302"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "WV",
"license": "21597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MedCorp-Tygart Valley Medical Specialties",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.