Individual provider Active NPI

John W Staggers III, PT

  • Physical Therapist
  • Keyser, WV
National Provider Identifier
1023063773
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
001354 Issued in WV
Practice address
160 N Sheridan Lane
Keyser, WV 26726
Phone
(304) 813-7839
Fax
(304) 822-4977
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 001354 WV Primary

Addresses

Primary practice location

160 N Sheridan Lane
Keyser, WV 26726

Mailing address

160 N Sheridan Lane
Keyser, WV 26726
Phone (304) 813-7839

Other identifiers 7

IdentifierTypeStateIssuer
0006OtherCAREFIRST BCBS OF DC NCA
0157287000MedicaidWV
225928OtherMAMSI
53386804OtherMDBLUECROSS BLUESHIELD
650016655OtherRAILROAD MEDICARE
7178361OtherAETNA
1017320OtherWVWORKERS COMPENSATION

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
18038MDMDSocial Worker
001354WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Staggers, Heare, & Whiteman, P.a. Physical Therapist Past Accepting new patients
Staggers Heare & Whiteman PA Physical Therapist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1023063773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N SHERIDAN LANE",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "26726",
            "telephone_number": "304-813-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N SHERIDAN LANE",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "26726",
            "telephone_number": "304-813-7839",
            "fax_number": "304-822-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGGERS",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "001354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF DC NCA",
            "identifier": "0006",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157287000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "225928",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "53386804",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650016655",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7178361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "1017320",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keyser, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.