Organization Active NPI

Neurology Clinic, Inc

  • Neurology Physician
  • Ronceverte, WV
National Provider Identifier
1780877548
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
21743 Issued in WV
Legal business name
NEUROLOGY CLINIC, INC
Practice address
100 Taylor LN
Ronceverte, WV 24970-1337
Phone
(304) 645-5185
Fax
(904) 645-5184
NPI assigned
Aug 23, 2007
Last updated
Jan 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Authorized official

Name
Pauline L. Miley
Title
Manager
Phone
(304) 645-5185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 21743 WV Primary

Addresses

Primary practice location

100 Taylor LN
Ronceverte, WV 24970-1337

Mailing address

PO Box 1670
Lewisburg, WV 24901-4670
Phone (304) 645-5185

Other identifiers 1

IdentifierTypeStateIssuer
DC7262OtherPALMETTO GBA

National Provider Directory

National Provider Directory

Locations

169 E Dawkins Dr
RR 2
Lewisburg, WV 24901

169 E Dawkins Dr
RR 2
Lewisburg, WV 24901
Phone (304) 536-2030

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1780877548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1670",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249014670",
            "telephone_number": "304-645-5185",
            "fax_number": "904-645-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TAYLOR LN",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249701337",
            "telephone_number": "304-645-5185",
            "fax_number": "904-645-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "MILEY",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "304-645-5185"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WV",
            "license": "21743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "DC7262",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.