Active NPI
Clay County Board of Health
- Case Management Agency
- Clay, WV
National Provider Identifier
1396928099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Legal business name
- CLAY COUNTY BOARD OF HEALTH
- Practice address
- 452 Main Street
Clay, WV 25043 - Phone
- (304) 587-4269
- Fax
- (304) 587-7415
- NPI assigned
- Dec 17, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Linda K Klotzbach
- Title
- Local Health Administrator I
- Phone
- (304) 587-4269
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Primary |
Addresses
Primary practice location
452 Main Street
Clay, WV 25043
Mailing address
PO Box 36
Clay, WV 25043-0036
Phone (304) 587-4269
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0021182002 | Medicaid | WV |
Other names 1
- Clay County Health Department
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160915000229 | WV | Part B Supplier - Clinic/Group Practice | 5496750481 |
Receives reassigned benefits from 1 practitioner Practice locations: Clay, WV |
National Provider Directory
National Provider Directory- Tax ID family
- Clay County Board of Health
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Case Management Agency
- Clay, WV
- NPI 1447640388
Practitioners 1
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": "1197849600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1197849600000",
"number": "1396928099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 36",
"city": "CLAY",
"state": "WV",
"postal_code": "250430036",
"telephone_number": "304-587-4269",
"fax_number": "304-587-7415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "452 MAIN STREET",
"city": "CLAY",
"state": "WV",
"postal_code": "25043",
"telephone_number": "304-587-4269",
"fax_number": "304-587-7415"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLAY COUNTY BOARD OF HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-17",
"last_updated": "2007-12-17",
"status": "A",
"authorized_official_last_name": "KLOTZBACH",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "LOCAL HEALTH ADMINISTRATOR I",
"authorized_official_telephone_number": "304-587-4269",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0021182002",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Clay County Health Department",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Clay, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.