Organization Active NPI

Charles S. McClung Sr., DO

  • Family Medicine Physician
  • Lewisburg, WV
National Provider Identifier
1497944607
Registry record updated Aug 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1484 Issued in WV
Legal business name
CHARLES S. MCCLUNG SR., DO
Doing business as
McClung Health and Wellness Center
Practice address
226 Skylar Dr
Lewisburg, WV 24901-9383
Phone
(304) 647-9971
Fax
(304) 647-9973
NPI assigned
Oct 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2009

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

Authorized official

Name
Dr. Charles Scott McClung Sr., D.O.
Title
Owner/Physician
Phone
(304) 647-9971

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 1484 WV Primary

Addresses

Primary practice location

226 Skylar Dr
Lewisburg, WV 24901-9383

Mailing address

PO Box 1849
Lewisburg, WV 24901-4849
Phone (304) 647-9971

Other identifiers 1

IdentifierTypeStateIssuer
5630417000MedicaidWV

Other names 1

  • McClung Health and Wellness Center Doing business as

National Provider Directory

National Provider Directory

Locations

226 Skylar Dr
Lewisburg, WV 24901
Phone (304) 645-3435

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1497944607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1849",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249014849",
            "telephone_number": "304-647-9971",
            "fax_number": "304-647-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 SKYLAR DR",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019383",
            "telephone_number": "304-647-9971",
            "fax_number": "304-647-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES S. MCCLUNG SR., DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "MCCLUNG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "304-647-9971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5630417000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McClung Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewisburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; 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.