NPIMap

Organization Active NPI

Monongahela Valley Association of Health Center, Inc.

Doing business as MVA Fairview Clinic

  • Clinic/Center
  • Fairview, WV
National Provider Identifier
1407034887
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTER, INC.
Doing business as
MVA Fairview Clinic
Practice address
400 Main Street
Fairview, WV 26570
Phone
(304) 367-8710
Fax
(304) 366-9529
NPI assigned
Feb 7, 2008
Last updated
Oct 28, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Ms. Nancy L Vandergrift
Title
President
Phone
(304) 367-8740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

400 Main Street
Fairview, WV 26570

Mailing address

1322 Locust Ave
P O Box 1112
Fairmont, WV 26554-1436
Phone (304) 367-8710

Other names 1

  • MVA Fairview Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080220000201 WV Part B Supplier - Public Health/Welfare Agency 6800991977 Receives reassigned benefits from 20 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shinnston, WV; Mannington, WV; Fairmont, WV; Farmington, WV

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Mva X-Ray Fairmont Clinic

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1407034887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 LOCUST AVE",
            "address_2": "P O BOX 1112",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541436",
            "telephone_number": "304-367-8710",
            "fax_number": "304-366-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MAIN STREET",
            "city": "FAIRVIEW",
            "state": "WV",
            "postal_code": "26570",
            "telephone_number": "304-367-8710",
            "fax_number": "304-366-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS INC",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "VANDERGRIFT",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-367-8740",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MVA Fairview Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairview, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.