NPIMap

Organization Active NPI

Clay Co. Dev

Doing business as Tender Heart

  • Early Intervention Provider Agency
  • Summersville, WV
National Provider Identifier
1538331178
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
21874703 Issued in WV
Legal business name
CLAY CO. DEV
Doing business as
Tender Heart
Practice address
812 Northside Dr
Summersville, WV 26651-2028
Phone
(304) 872-9115
Fax
(304) 872-9227
NPI assigned
Mar 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Audrey M. McKinney
Title
Office Manager/Billing Clerk
Phone
(304) 872-9115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 21874703 WV Primary

Addresses

Primary practice location

812 Northside Dr
Summersville, WV 26651-2028

Mailing address

812 Northside Dr
Summersville, WV 26651-2028
Phone (304) 872-9115

Other identifiers 1

IdentifierTypeStateIssuer
33810011359MedicaidWV

Other names 1

  • Tender Heart Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clay County Development Corporation5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1538331178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 NORTHSIDE DR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266512028",
            "telephone_number": "304-872-9115",
            "fax_number": "304-872-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 NORTHSIDE DR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266512028",
            "telephone_number": "304-872-9115",
            "fax_number": "304-872-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY CO. DEV",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER/BILLING CLERK",
        "authorized_official_telephone_number": "304-872-9115"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "WV",
            "license": "21874703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33810011359",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tender Heart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summersville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.