NPIMap

Organization Active NPI

Fayette Clinic, PLLC

  • Family Medicine Physician
  • Lochgelly, WV
National Provider Identifier
1851580468
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAYETTE CLINIC, PLLC
Practice address
1 Physicians Plaza
Lochgelly, WV 25866
Phone
(304) 469-3334
NPI assigned
Oct 19, 2007
Last updated
Jun 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Ms. Darlene Newell, RN
Title
Office Manager
Phone
(304) 469-3334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X WV Primary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X WV

Addresses

Primary practice location

1 Physicians Plaza
Lochgelly, WV 25866

Mailing address

1 Physicians Plaza
PO Box 130
Lochgelly, WV 25866
Phone (304) 469-3334

Other identifiers 5

IdentifierTypeStateIssuer
0206041003MedicaidWV
200164OtherWVFEDERAL BLACK LUNG
0206041000MedicaidWV
513906OtherWVRURAL HEALTH PROVIDER #
001708474OtherWVBC/BS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1851580468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PHYSICIANS PLAZA",
            "address_2": "PO BOX 130",
            "city": "LOCHGELLY",
            "state": "WV",
            "postal_code": "25866",
            "telephone_number": "304-469-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PHYSICIANS PLAZA",
            "city": "LOCHGELLY",
            "state": "WV",
            "postal_code": "25866",
            "telephone_number": "304-469-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "NEWELL",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-469-3334",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206041003",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "200164",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206041000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH PROVIDER #",
            "identifier": "513906",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "001708474",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lochgelly, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.