Active NPI
Peggy McCormick
- Social Worker
- Millwood, WV
National Provider Identifier
1023553443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- AP00944379
- Practice address
- 6775 Point Pleasant Rd
Millwood, WV 25262-8100 - Phone
- (304) 273-0112
- Fax
- (304) 273-0115
- NPI assigned
- Dec 20, 2016
- Last updated
- Dec 20, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | AP00944379 | WV | Primary |
| Social Worker | 104100000X | 1600061 | OH |
Addresses
Primary practice location
6775 Point Pleasant Rd
Millwood, WV 25262-8100
Mailing address
6775 Point Pleasant Rd
Millwood, WV 25262-8100
Phone (304) 273-0112
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP00944379 | Other | WV | BOARD OF SOCIAL WORK |
| 1600061 | Other | OH | COUNSELOR SOCIAL WORKER MARRIAGE & FAMILY THERAPIST BOARD |
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 |
|---|---|---|---|
| 1600061 | OH | MD | Social Worker |
| AP00944379 | WV | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Lifeclinics Inc | Past | Accepting new patients |
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.
-
dba New Life Clinic
- Substance Use Disorder Rehabilitation Clinic/Center
- Beckley, WV
- NPI 1417606831
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482192000000",
"number": "1023553443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6775 POINT PLEASANT RD",
"city": "MILLWOOD",
"state": "WV",
"postal_code": "252628100",
"telephone_number": "304-273-0112",
"fax_number": "304-273-0115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6775 POINT PLEASANT RD",
"city": "MILLWOOD",
"state": "WV",
"postal_code": "252628100",
"telephone_number": "304-273-0112",
"fax_number": "304-273-0115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "PEGGY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-20",
"last_updated": "2016-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WV",
"license": "AP00944379",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "1600061",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF SOCIAL WORK",
"identifier": "AP00944379",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COUNSELOR SOCIAL WORKER MARRIAGE & FAMILY THERAPIST BOARD",
"identifier": "1600061",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Millwood, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.