NICOLE DANIELLE CLENDENIN (NPI# 1770127516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770127516 |
| Entity Type | Individual |
| Full Name | NICOLE DANIELLE CLENDENIN |
| Credential | FNP |
| Practice Address |
314 Goff Mountain Rd Ste 16 Charleston WV 25313-6600 |
| Mailing Address |
20309 Winfield Rd Fraziers Bottom WV 25082-6818 |
| Practice Telephone | 3042042091 |
| Mailing Telephone | 3045458478 |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2019-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 103825 | WV | Allopathic & Osteopathic Physicians |
| Street Address |
314 GOFF MOUNTAIN RD STE 16 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25313-6600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043869183 | Shante Hamrick | Technician | 5130 Waycross Drive, Cross Lanes, WV 25313 | 2019-09-11 |
| 1942755061 | John Brian Thomas | Pharmacist | 5450 Big Tyler Rd., Cross Lanes, WV 25313 | 2016-08-18 |
| 1902221310 | David Alan Haynes Jr. | Physical Therapist | 314 Goff Mountain Rd. (ste 13), Ste 13, Cross Lanes, WV 25313 | 2014-02-20 |
| 1073897344 | Rhonda M Knight | Physical Therapist | 314 Goff Mtn. Rd., Suite 13, Cross Lanes, WV 25313 | 2011-10-05 |
| 1083853683 | Mitri A. Ghareeb, Dds, PC | Dentist | 5480 Big Tyler Road, Suite 1, Cross Lanes, WV 25313 | 2009-02-05 |
| 1295944460 | John C. Taylor | Pharmacist | 5455f Big Tyler Rd., Cross Lanes, WV 25313 | 2007-05-22 |
| 1194890657 | Linda O Workman | Psychologist | 202 Glass Drive, Cross Lanes, WV 25313 | 2006-11-21 |
| 1306910104 | William Albert Reynolds IIi | Dentist | 5304 Koontz Dr, Cross Lanes, WV 25313 | 2006-11-20 |
| 1770676413 | Mark S. Calfee, Dc | Chiropractor | 5390 Big Tyler Rd, Cross Lanes, WV 25313 | 2006-10-02 |
| 1578663589 | Dewey Wilson Mann Jr. | Dentist | 104 Goff Mtn Rd, Cross Lanes, WV 25313 | 2006-09-22 |
| Find all providers in zip 25313 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632809 | Caitlin Marie Stoll | Pediatrics | 2244 Ashley Crossing Dr Unit 536, Charleston, SC 29414-6168 | 2020-06-08 |
| 1134743420 | Elizabeth Alden Mccants | Pediatrics | 125 Doughty St Ste 520d, Charleston, SC 29403-5736 | 2020-06-02 |
| 1871059238 | Aminah Fraser- Abdur Rahim | Pediatrics | 1373 W Lenevar Dr, Charleston, SC 29407-5148 | 2019-02-11 |
| 1720518384 | Nicholas Matthew Cundiff | Pediatrics | 135 Rutledge Ave Dept Of, Charleston, SC 29425-8903 | 2017-06-15 |
| 1649632225 | Collin Dubick | Pediatrics | 1118 Sea Eagle Watch, Charleston, SC 29412-8249 | 2016-03-23 |
| 1417338781 | Heather Michelle Greene | Pediatrics | 169 Ashlet Avenue, Room 202 Main Hospital Msc 333, Charleston, SC 29425 | 2015-06-12 |
| 1780098160 | Matthew John Saia | Pediatrics | 2124 Telfair Way, Charleston, SC 29412-2370 | 2014-06-13 |
| 1770922601 | Lauren Simpson Tipton | Pediatrics | 1243 Savannah Hwy Ste B, Charleston, SC 29407-7817 | 2013-06-25 |
| 1467747527 | Pratikkumar Patel | Pediatrics | 830 Pennsylvania Ave Ste 401, Charleston, WV 25302-3390 | 2011-06-16 |
| 1245420058 | Christy Lynn Robinson | Pediatrics | 1538 Kanawha Blvd E, Charleston, WV 25311-2435 | 2007-07-27 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25313 |
Please comment or provide details below to improve the information on NICOLE DANIELLE CLENDENIN.
| 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.