New Covenant Pediatric Center, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

1878 Issued in WV

Legal business name

NEW COVENANT PEDIATRIC CENTER, PLLC

Practice address

RR 2 Box 375G
Lewisburg, WV 24901-9346

Phone

(304) 645-8009

Fax

(304) 645-8011

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy J York, DO

Title

Owner

Phone

(304) 645-8009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417071812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON STREET, WEST",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "24901",
            "telephone_number": "304-645-8009",
            "fax_number": "304-645-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 375G",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019346",
            "telephone_number": "304-645-8009",
            "fax_number": "304-645-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW COVENANT PEDIATRIC CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-645-8009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WV",
            "license": "1878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Lewisburg, WV
• Providers in Lewisburg, WV by specialty
• Primary Care Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.