Active NPI
Jennifer McClung
- Licensed Practical Nurse
- Charleston, WV
National Provider Identifier
1548987258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 39792
- Practice address
- 900 Virginia St E
Charleston, WV 25301-2835 - Phone
- (681) 313-4759
- NPI assigned
- Oct 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 39792 | WV | Primary |
Addresses
Primary practice location
900 Virginia St E
Charleston, WV 25301-2835
Mailing address
900 Virginia St E
Charleston, WV 25301-2835
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00 | Medicaid | WV | |
| 05 | Medicaid | WV |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Cellphone | ||
| Other URL | Maxim |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39792 | WV | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1548987258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 VIRGINIA ST E",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253012835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 VIRGINIA ST E",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253012835",
"telephone_number": "681-313-4759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLUNG",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-24",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WV",
"license": "39792",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05",
"state": "WV"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Cellphone",
"affiliation": "N",
"address_1": "2799 Rich Creek Rd",
"city": "Ansted",
"state": "WV",
"country_code": "US",
"postal_code": "258129618",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Maxim",
"affiliation": "N",
"address_1": "900 Virginia St E",
"city": "Charleston",
"state": "WV",
"country_code": "US",
"postal_code": "253012835",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.