Individual provider Active NPI

Jason Clonnie Trusty, PA C

  • Physician Assistant
  • Charleston, WV
National Provider Identifier
1467566463
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
01157 Issued in WV
Practice address
208 Maccorkle Ave SE
Charleston, WV 25314-1160
Phone
(304) 343-4300
Fax
(304) 343-5476
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 01157 WV Primary

Addresses

Primary practice location

208 Maccorkle Ave SE
Charleston, WV 25314-1160

Mailing address

208 Maccorkle Ave SE
Charleston, WV 25314-1160
Phone (304) 343-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051205000466 WV Practitioner - Physician Assistant 2860412962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WV Asthma and Allergy Centers IncGroup PAC ID 8527137728, 8 clinicians

Practice addresses (Care Compare)

208 Maccorkle Ave SE
Charleston, WV 25314-1160
Phone 304343430099

Hospital & facility affiliations

  • Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058
  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
WV Asthma and Allergy Centers, Inc. CurrentSince Jun 1, 2008 Accepting new patients
WV Asthma and Allergy Centers, Inc. CurrentSince Jun 1, 2008 Accepting new patients

Locations

246 George St
Beckley, WV 25801
Phone (304) 253-7100

208 Maccorkle Ave SE
Charleston, WV 25314
Phone (304) 343-4300

100 Main Ave
Logan, WV 25601
Phone (304) 831-6700

118 Nick Savas Dr
Logan, WV 25601
Phone (304) 752-4045

418 Grand Park Dr
Ste 326
Parkersburg, WV 26105
Phone (304) 422-1400

418 Grand Park Dr
Bldg Iii
Parkersburg, WV 26105

598 Church St S
#A
Ripley, WV 25271
Phone (304) 372-3033

Organizations & group practices 2

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

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1467566463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141160",
            "telephone_number": "304-343-4300",
            "fax_number": "304-343-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141160",
            "telephone_number": "304-343-4300",
            "fax_number": "304-343-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUSTY",
        "first_name": "JASON",
        "middle_name": "CLONNIE",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.