Active NPI
Marietta Babayev, M.D.
- Physical Medicine & Rehabilitation Physician
- South Charleston, WV
National Provider Identifier
1033161666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 20710
- Practice address
- 313 Maccorkle Ave SW
South Charleston, WV 25303-1263 - Phone
- (304) 746-3706
- Fax
- (304) 744-8195
- NPI assigned
- May 16, 2006
- 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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 20710 | WV | Primary |
| Physical Medicine & Rehabilitation Physician | 208100000X | 35.081228 | OH |
Addresses
Primary practice location
313 Maccorkle Ave SW
South Charleston, WV 25303-1263
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (304) 744-2300
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000185283 | Other | OH | UNISON MEDICAID |
| 250013237 | Other | RR MEDICARE | |
| 2306972 | Other | OH | MOLINA MEDICAID |
| 1808136000 | Medicaid | WV | |
| 310917085158 | Other | OH | CARESOURCE MEDICAID |
| 001720906 | Other | MOUNTAIN STATE BCBS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.081228 | OH | MD | Physical Medicine & Rehabilitation Physician |
| 20710 | WV | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409702400000",
"number": "1033161666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "304-744-2300",
"fax_number": "304-744-8195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 MACCORKLE AVE SW",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253031263",
"telephone_number": "304-746-3706",
"fax_number": "304-744-8195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BABAYEV",
"first_name": "MARIETTA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-16",
"last_updated": "2014-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "WV",
"license": "20710",
"primary": true
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "OH",
"license": "35.081228",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON MEDICAID",
"identifier": "000000185283",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "250013237",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA MEDICAID",
"identifier": "2306972",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1808136000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE MEDICAID",
"identifier": "310917085158",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOUNTAIN STATE BCBS",
"identifier": "001720906",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in South Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.