Active NPI
Derek Tinney
- Personal Care Attendant
- Summersville, WV
National Provider Identifier
1023701349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 901 Broad St Ste 101
Summersville, WV 26651-1748 - Phone
- (304) 872-9531
- NPI assigned
- Jun 1, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
901 Broad St Ste 101
Summersville, WV 26651-1748
Mailing address
7510 Deer Branch Rd
Roanoke, VA 24019-3120
Phone (304) 872-9531
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1023701349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7510 DEER BRANCH RD",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240193120",
"telephone_number": "304-872-9531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 BROAD ST STE 101",
"city": "SUMMERSVILLE",
"state": "WV",
"postal_code": "266511748",
"telephone_number": "304-872-9531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TINNEY",
"first_name": "DEREK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-01",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"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 Jun 1, 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.