KEVIN M CLARKE (NPI# 1487664835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487664835 |
| Entity Type | Individual |
| Full Name | KEVIN M CLARKE |
| Credential | MD |
| Practice Address |
48 Vip Way Fairmont WV 26554 |
| Mailing Address |
200 Rt 98 West Suite 107 Nutter Fort WV 26301 |
| Practice Telephone | 3043666200 |
| Practice Fax Number | 3043664927 |
| Mailing Telephone | 3046235711 |
| Mailing Fax Number | 3046240461 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2017-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 15547 | WV | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 15547 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | BCBS WV | 001722242 | 01 |
| WV | 0041752000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811025489 | Kevin Richard Clarke | Pediatrics | 505 Parnassus Ave., M691, San Francisco, CA 94143-0110 | 2007-03-02 |
| 1598789265 | Kevin O. Clarke | Surgery | 90 Bergen St, Doc 7100, Newark, NJ 07103-2425 | 2006-07-27 |
| 1063475432 | Kevin Clarke | Physician Assistant | 333 Madison St, Joliet, IL 60435-8200 | 2006-04-07 |
| Street Address |
48 VIP WAY |
| City | FAIRMONT |
| State | WV |
| Zip Code | 26554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497680 | Vanquisha Clay | Technician | 118 Conaway St, Fairmont, WV 26554 | 2020-11-06 |
| 1851903363 | Denise S Greer | Technician | 1029 Prickett Road, Fairmont, WV 26554 | 2020-08-18 |
| 1730790775 | Darla Lee Mcrobie | Technician | 105 C'anna Square, Fairmont, WV 26554 | 2020-08-13 |
| 1376025718 | Jason Batten | Counselor | 621 Maryland Ave, Fairmont, WV 26554 | 2018-09-02 |
| 1437669066 | Ultimate Health & Wellness, LLC | Naturopath | 2862 Whitehall Blvd, Whitehall, WV 26554 | 2017-10-10 |
| 1457872376 | Michele R Lilley | Nurse Practitioner | 177 Middletown Rd, Ste1, Upc Whitehall Medical, Fairmont, WV 26554 | 2017-06-30 |
| 1477906154 | Rebecca Hayes-merrill | Counselor | 212 Adams St., 3rd Floor, Fairmont, WV 26554 | 2016-07-19 |
| 1790173417 | Dennis Michael Lynch | Counselor | 5 Turf Lane, Fairmont, WV 26554 | 2015-01-05 |
| 1336558725 | Nicole Savage | Home Health Aide | 122 Abbott St, Fairmont, WV 26554 | 2014-08-11 |
| 1124434550 | Achuta Ram Aynampudi | Psychiatry & Neurology | 100 Stoney Hill Rd, Fairmont, WV 26554 | 2014-07-07 |
| Find all providers in zip 26554 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801173653 | Medexpress Urgent Care, Inc. - West Virginia | Emergency Medicine | 630 Fairmont Ave, Fairmont, WV 26554-5104 | 2011-11-08 |
| 1578893301 | Nathan C Berry | Emergency Medicine | 110 Meadowlane Ave, Fairmont, WV 26554-2154 | 2009-12-29 |
| 1699837294 | Robert Clayton Thompson Jr. | Emergency Medicine | 238 Colfax Camp Rd, Fairmont, WV 26554-8337 | 2006-12-14 |
| 1801338298 | Emergency Solutions Inc | Emergency Medicine | 1325 Locust Ave, Fairmont, WV 26554-1435 | 2016-11-16 |
| 1396123170 | Julia Murray | Emergency Medicine | 100 Stoney Hill Rd, Fairmont, WV 26554 | 2015-05-12 |
| 1033516646 | Michael L Ferrebee, M.d., Pllc | Emergency Medicine | 1325 Locust Ave, Fairmont, WV 26554-1435 | 2014-11-25 |
| 1205179280 | Susan A Mccollough | Emergency Medicine | 800 Medical Center Dr, Fairmont, MN 56031-4575 | 2013-03-28 |
| 1184925539 | Allegheny Emergency Physicians LLP | Emergency Medicine | 1325 Locust Ave, Fairmont, WV 26554-1435 | 2010-11-16 |
| 1558599936 | Luke K Espelund | Emergency Medicine | 800 Medical Center Dr, Fairmont, MN 56031-4575 | 2009-06-24 |
| 1912162256 | Timothy Snelson | Emergency Medicine | 800 Medical Center Dr, Fairmont, MN 56031 | 2008-07-25 |
| Find all providers in FAIRMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.