The Carson Black Lung Research and Education Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

THE CARSON BLACK LUNG RESEARCH AND EDUCATION CENTER

Practice address

40518 W Morgan Ave
Pennington Gap, VA 24277-1822

Phone

(252) 452-6075

Fax

(276) 318-0298

NPI assigned

Sep 27, 2018

Last updated

Jun 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Rodney Terry

Title

Chief Operating Officer

Phone

(252) 452-6075

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1558846261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 RIVERVIEW AVE FL 3",
            "city": "PINEVILLE",
            "state": "KY",
            "postal_code": "409771452",
            "telephone_number": "252-452-4080",
            "fax_number": "276-318-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40518 W MORGAN AVE",
            "city": "PENNINGTON GAP",
            "state": "VA",
            "postal_code": "242771822",
            "telephone_number": "252-452-6075",
            "fax_number": "276-318-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CARSON BLACK LUNG RESEARCH AND EDUCATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-27",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "252-452-6075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mona Speak, DNP, FNP-BC
• Kala Rutherford Stapleton
• Gregory Ray Stewart, R.PH.
• Valerie Renee Taylor, PTA
• Winston Joshua Terry
• Town of Pennington Gap
• Chanda Varandani, MD
• Jai K Varandani, MD
• Walgreen Co (Walgreens #19095)
• Wellmont Health System (Lee Regional Rehab Center)

• Clinic/Center in Pennington Gap, VA
• Providers in Pennington Gap, VA by specialty
• Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.