Organization Active NPI

Tygart Valley Medical Specialties, Inc

  • Multi-Specialty Clinic/Center
  • Elkins, WV
National Provider Identifier
1235596677
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
21597 Issued in WV
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

Updated by the provider on Sep 22, 2025

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)CodeLicenseStatePrimary
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 Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160816000329 WV Part B Supplier - Clinic/Group Practice 7416241351 Receives reassigned benefits from 4 practitioners
Practice locations: Elkins, WV; Petersburg, WV; Philippi, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D1070912Tygart Valley Medical Specialties, Inc911 Gorman Avenue Suite 201, Elkins, WV 26241Certificate of waiverJul 11, 2027

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.