Active NPI
Katelyn R Buzzo, PRSS
- Peer Specialist
- Summersville, WV
National Provider Identifier
1013670165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 23-9152
- Practice address
- 131 Wellness Dr
Summersville, WV 26651-5402 - Phone
- (304) 872-6503
- NPI assigned
- Oct 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 23-9152 | WV | Primary |
Addresses
Primary practice location
131 Wellness Dr
Summersville, WV 26651-5402
Mailing address
131 Wellness Dr
Summersville, WV 26651-5402
Phone (304) 872-6503
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23-9152 | WV | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703203200000",
"number": "1013670165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 WELLNESS DR",
"city": "SUMMERSVILLE",
"state": "WV",
"postal_code": "266515402",
"telephone_number": "304-872-6503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 WELLNESS DR",
"city": "SUMMERSVILLE",
"state": "WV",
"postal_code": "266515402",
"telephone_number": "304-872-6503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUZZO",
"first_name": "KATELYN",
"middle_name": "R",
"credential": "PRSS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-15",
"last_updated": "2023-12-22",
"certification_date": "2023-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WV",
"license": "23-9152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summersville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.