Simon McClure, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

17045 Issued in WV

Practice address

1160 Johnson Ave
Suite 105
Bridgeport, WV 26330

Phone

(304) 842-9084

Fax

(304) 842-9085

NPI assigned

Jul 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grayson and Associates PCGroup PAC ID 9032108253, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JFICCD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grayson and Associates PC

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1194772442
  Medicare reassignment Care Compare group NPD
• Psychiatric Associates

  • Psychiatry Physician
  • Bridgeport, WV
  • NPI 1790863744
  NPD (past)
• SVPS Psychiatric Services LLC

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1447528591
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386677813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 JOHNSON AVE",
            "address_2": "SUITE 105",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-842-9084",
            "fax_number": "304-842-9085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 JOHNSON AVE",
            "address_2": "SUITE 105",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-842-9084",
            "fax_number": "304-842-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "SIMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "17045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115260000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren McCarthy, RPH, PHARMD
• Mona D McCarthy, CRNA
• Jennifer McClain
• Mildred McClaskey
• Crystal McCloy
• Amanda Dawn McCray, L.M.T
• Elizabeth Nicole McCreight
• Rodney R McCullough, MA
• Kaila McGahan
• Heaven McGee, APRN

• Psychiatry Physician in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Psychiatry Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.