Jay Lee McClanahan, D.C.
Individual provider Active NPI Chiropractor · Nitro, WV
NPI 1245368240 · NPPES record last updated Feb 27, 2008
Key facts
- NPI
- 1245368240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 828 (WV)
- Practice address
- 642 Cross Lanes Dr
Nitro, WV 25143-1163 - Phone
- (304) 776-1520
- Fax
- (304) 776-1521
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College - West, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
642 Cross Lanes Dr
Nitro, WV 25143-1163
Phone (304) 776-1520
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050615000931 | WV | Practitioner - Chiropractic | 4587608203 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. J Chiropractic and Wellness Center | Chiropractor | Current |
Accepting new patients |
| Dr. J Chiropractic & Wellness Center | Chiropractor | Past |
Accepting new patients |
Locations
642 Cross Lanes Dr
Nitro, WV 25143
Phone (304) 776-1520
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 828 | WV | Yes |
Addresses
Primary practice location
642 Cross Lanes Dr
Nitro, WV 25143-1163
Mailing address
642 Cross Lanes Dr
Nitro, WV 25143-1163
Phone (304) 776-1520
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810002674 | Medicaid | WV | |
| 7509681 | Other | WV | AETNA |
| 1060823 | Other | WV | AMERICAN SPECIALTY HEALTH |
| 306672 | Other | WV | CARELINK |
| 91087 | Other | WV | UNICARE |
| AS40510400001 | Other | WV | CIGNA HEALTHCARE |
Other providers in Nitro, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.