NPIMap

Organization Active NPI

Highland Clarksburg Hospital Inc.

  • Psychiatry Physician
  • Clarksburg, WV
National Provider Identifier
1649941279
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
HIGHLAND CLARKSBURG HOSPITAL INC.
Practice address
3 Hospital PLZ
Clarksburg, WV 26301-9316
Phone
(304) 969-3102
Fax
(304) 326-0089
NPI assigned
Sep 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Whitney Renee Patterson
Title
Cfo
Phone
(304) 969-3143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3 Hospital PLZ
Clarksburg, WV 26301-9316

Mailing address

3 Hospital PLZ
Clarksburg, WV 26301-9316
Phone (304) 969-3102

Other identifiers 1

IdentifierTypeStateIssuer
1710317276MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgoodykoontz@highlandhospital.net Direct

National Provider Directory

National Provider Directory
Tax ID family
Highland-Clarksburg Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1649941279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HOSPITAL PLZ",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263019316",
            "telephone_number": "304-969-3102",
            "fax_number": "304-326-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HOSPITAL PLZ",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263019316",
            "telephone_number": "304-969-3102",
            "fax_number": "304-326-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND CLARKSBURG HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "304-969-3143"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710317276",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgoodykoontz@highlandhospital.net",
            "affiliation": "N",
            "endpointDescription": "CMO",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3 Hospital Plz",
            "city": "Clarksburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263019316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarksburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.