Manchin Clinic South, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MANCHIN CLINIC SOUTH, LLC

Practice address

181 Middletown Loop
White Hall, WV 26554-8703

Phone

(304) 367-9170

Fax

(304) 367-9180

NPI assigned

Apr 10, 2008

Last updated

Jul 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Manchin, D.O.NPI 1134231640

Title

Sole Member

Phone

(304) 367-9170

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Manchin II, DO

  • Family Medicine Physician
  • Farmington, WV
  • NPI 1134231640
  Medicare reassignment NPD Authorized official
• Brandi Renee Asterino, LICSW

  • Clinical Social Worker
  • Fairmont, WV
  • NPI 1386974947
  Medicare reassignment NPD
• Angela M Hager, PA

  • Medical Physician Assistant
  • Farmington, WV
  • NPI 1124299813
  Medicare reassignment

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1265605208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 MIDDLETOWN CIRCLE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "26554",
            "telephone_number": "304-367-9170",
            "fax_number": "304-367-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 MIDDLETOWN LOOP",
            "city": "WHITE HALL",
            "state": "WV",
            "postal_code": "265548703",
            "telephone_number": "304-367-9170",
            "fax_number": "304-367-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHIN CLINIC SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "MANCHIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "304-367-9170",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011616",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• American Pharmacy
• Kristin Lynn Canterbury, M.D.
• Sandra K Cunningham, DC
• DRS Sharps and Looper of Fairmont PLLC
• Robert D Flint, DDS
• Mon Health Marion Neighborhood Hospital, Inc. (Mon Health Marion)
• Mon Health Marion Neighborhood Hospital, Inc. (Mon Health Marion)
• Ahmed Mourad
• Sandra K Cunningham, DC
• Riley Paige Skeens

• Clinic/Center in White Hall, WV
• Providers in White Hall, WV by specialty
• Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.