Individual provider Active NPI

David Ferrell II

  • Physical Therapy Assistant
  • Elizabeth, WV
National Provider Identifier
1053029652
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
0995 Issued in WV
Practice address
69 Maze PLZ
Elizabeth, WV 26143-5127
Phone
(304) 275-5001
NPI assigned
Nov 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0995 WV Primary

Addresses

Primary practice location

69 Maze PLZ
Elizabeth, WV 26143-5127

Mailing address

69 Maze PLZ
Elizabeth, WV 26143-5127
Phone (304) 275-5001

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
0995WVMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1053029652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 MAZE PLZ",
            "city": "ELIZABETH",
            "state": "WV",
            "postal_code": "261435127",
            "telephone_number": "304-275-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 MAZE PLZ",
            "city": "ELIZABETH",
            "state": "WV",
            "postal_code": "261435127",
            "telephone_number": "304-275-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRELL",
        "first_name": "DAVID",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-11",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "0995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.