Chapmanville Primary Care Clinic

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

CHAPMANVILLE PRIMARY CARE CLINIC

Practice address

462 Main St
Chapmanville, WV 25508-4574

Phone

(304) 310-2517

Fax

(304) 310-2520

NPI assigned

Feb 3, 2020

Organization subpart

No

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

Authorized official

Name

Wendy White

Title

Credentialing Specialist

Phone

(304) 688-7027

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Rural health clinic certification: CCN 513926

Legal name

CHAPMANVILLE PRIMARY CARE CLINIC LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Feb 18, 2021

Last certification

Feb 18, 2021

Ownership / control type

1C

Facility address

462 Main Street
Chapmanville, WV 25508

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1811528318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1062",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "255081062",
            "telephone_number": "304-310-2517",
            "fax_number": "304-310-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 MAIN ST",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "255084574",
            "telephone_number": "304-310-2517",
            "fax_number": "304-310-2520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Main St",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "WV",
            "postal_code": "256013607",
            "country_code": "US",
            "telephone_number": "304-752-9450",
            "fax_number": "304-752-9452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHAPMANVILLE PRIMARY CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "304-688-7027"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "462 Main St",
            "city": "Chapmanville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "255084574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chapmanville Chiropractic
• Chapmanville Family Chiropractic
• Chapmanville Medical Center, Inc
• Chapmanville Pharmacy Inc
• Chapmanville Primary Care Clinic
• Amber M Clay, LPC
• Tanner Clay
• Savanna Clayton
• Candra Cline
• Denney E Collins

• Rural Health Clinic/Center in Chapmanville, WV
• Providers in Chapmanville, WV by specialty
• Rural Health Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.