Tammy Dawn Clark-Moats

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95523 Issued in WV

Practice address

21 E Main St Ste 302
Buckhannon, WV 26201-2910

Phone

(304) 473-6802

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1457075434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 LIGHT HOLLOW RD",
            "city": "HACKER VALLEY",
            "state": "WV",
            "postal_code": "262228402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E MAIN ST STE 302",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012910",
            "telephone_number": "304-473-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-MOATS",
        "first_name": "TAMMY",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "95523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop/tablet",
            "affiliation": "N",
            "address_1": "21 E Main St Ste 302",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262012910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop/tablet",
            "affiliation": "N",
            "address_1": "21 E Main St Ste 302",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262012910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cheryl L. Bennett OD, PLLC
• Brittany Chewning
• Brittney Chewning
• Danna Chewning
• Sara Beth Chipps
• Denise Clark
• Marlene Clark
• Sabrina L Clark
• Carol Clay
• Robert Clay

• All providers in Buckhannon, WV
• Registered Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.