NPIMap

Organization Active NPI

Little Beaver Family Clinic

  • Family Nurse Practitioner
  • Craigsville, WV
National Provider Identifier
1558447805
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
52802 Issued in WV
Legal business name
LITTLE BEAVER FAMILY CLINIC
Practice address
16130 Webster Rd.
Craigsville, WV 26205-1728
Phone
(304) 742-3570
Fax
(304) 742-3572
NPI assigned
Oct 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Authorized official

Name
Cheryl L White, APRN
Title
Owner/President
Phone
(304) 742-3570

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 52802 WV Primary

Addresses

Primary practice location

16130 Webster Rd.
Craigsville, WV 26205-1728

Mailing address

PO Box 1728
Craigsville, WV 26205-1728
Phone (304) 742-3570

Other identifiers 3

IdentifierTypeStateIssuer
001784453OtherWVMTN STATE BCBS
3810001807MedicaidWV
DE7201OtherWVRR MCARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349827200000",
    "number": "1558447805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1728",
            "city": "CRAIGSVILLE",
            "state": "WV",
            "postal_code": "262051728",
            "telephone_number": "304-742-3570",
            "fax_number": "304-742-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16130 WEBSTER RD.",
            "city": "CRAIGSVILLE",
            "state": "WV",
            "postal_code": "262051728",
            "telephone_number": "304-742-3570",
            "fax_number": "304-742-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE BEAVER FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-30",
        "last_updated": "2012-10-10",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "304-742-3570",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "52802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MTN STATE BCBS",
            "identifier": "001784453",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001807",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCARE",
            "identifier": "DE7201",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Craigsville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.