Individual provider Active NPI

Jessica Miller

  • Health & Wellness Coach
  • Bruceton Mills, WV
National Provider Identifier
1003692039
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
License
1220792731 Issued in WV
Practice address
15630 N Preston Hwy
Bruceton Mills, WV 26525-7036
Phone
(304) 379-7000
NPI assigned
Sep 6, 2023
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X 1220792731 WV Primary

Addresses

Primary practice location

15630 N Preston Hwy
Bruceton Mills, WV 26525-7036

Mailing address

15630 N Preston Hwy
Bruceton Mills, WV 26525-7036
Phone (304) 379-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1220792731WVMDHealth & Wellness Coach

Practice roles

OrganizationSpecialtyStatusNew patients
Bruceton Wellness Center PLLC CurrentSince Sep 10, 2023 Accepting new patients

Locations

15630 N Preston Hwy
Bruceton Mls, WV 26525
Phone (304) 379-7000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1003692039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15630 N PRESTON HWY",
            "city": "BRUCETON MILLS",
            "state": "WV",
            "postal_code": "265257036",
            "telephone_number": "304-379-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15630 N PRESTON HWY",
            "city": "BRUCETON MILLS",
            "state": "WV",
            "postal_code": "265257036",
            "telephone_number": "304-379-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "WV",
            "license": "1220792731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bruceton Mills, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.