Organization Active NPI

Neveah Health & Wellness Center, PLLC

  • Family Medicine Physician
  • South Charleston, WV
National Provider Identifier
1003213471
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEVEAH HEALTH & WELLNESS CENTER, PLLC
Practice address
538 3Rd Avenue
South Charleston, WV 25303
Phone
(304) 362-9883
Fax
(304) 362-9881
NPI assigned
Dec 1, 2014
Last updated
Mar 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Mr. Andrew Boothe
Title
Office Manager
Phone
(304) 549-8479

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X WV Primary

Addresses

Primary practice location

538 3Rd Avenue
South Charleston, WV 25303

Mailing address

538 3Rd Avenue
South Charleston, WV 25303
Phone (304) 362-9883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141222002298 WV Part B Supplier - Clinic/Group Practice 9739402868 Receives reassigned benefits from 2 practitioners
Practice locations: South Charleston, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2087332Neveah Health & Wellness Center PLLC538 3Rd Avenue, South Charleston, WV 25303Provider-performed microscopyNov 20, 2026

National Provider Directory

National Provider Directory

Locations

538 3rd Ave
South Charleston, WV 25303
Phone (304) 362-9883

Practitioners & affiliated clinicians

Practitioners 4

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": "1417392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1003213471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 3RD AVENUE",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25303",
            "telephone_number": "304-362-9883",
            "fax_number": "304-362-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 3RD AVENUE",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25303",
            "telephone_number": "304-362-9883",
            "fax_number": "304-362-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVEAH HEALTH & WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-01",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "BOOTHE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-549-8479",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.