Organization Active NPI

Clinch Valley Pulmonology LLC

  • Pulmonary Disease Physician
  • Richlands, VA
National Provider Identifier
1306835673
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
CLINCH VALLEY PULMONOLOGY LLC
Practice address
2951 West Front Street
Suite 1000
Richlands, VA 24641
Phone
(276) 964-6966
Fax
(276) 963-3690
NPI assigned
Oct 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Authorized official

Name
Karen Merritt
Title
Director
Phone
(276) 964-6966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

2951 West Front Street
Suite 1000
Richlands, VA 24641

Mailing address

2951 West Front Street
Suite 1000
Richlands, VA 24641
Phone (276) 964-6966

Other identifiers 2

IdentifierTypeStateIssuer
0210133000MedicaidWV
1306835673MedicaidVA

National Provider Directory

National Provider Directory

Locations

2951 W FRNT St Ste 1000
Ste 1000
Richlands, VA 24641
Phone (276) 596-6655

Practitioners & affiliated clinicians

Practitioners 3

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": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1306835673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 WEST FRONT STREET",
            "address_2": "SUITE 1000",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "24641",
            "telephone_number": "276-964-6966",
            "fax_number": "276-963-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 WEST FRONT STREET",
            "address_2": "SUITE 1000",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "24641",
            "telephone_number": "276-964-6966",
            "fax_number": "276-963-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINCH VALLEY PULMONOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "276-964-6966"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0210133000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306835673",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richlands, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.