Jacqueline Lee Lickliter, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2950 Issued in WV

Practice address

230 George St Ste 2
Beckley, WV 25801-2620

Phone

(304) 255-2878

NPI assigned

May 17, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

West Virginia School of Osteopathic Medicine, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.lickliter@camc.cernerdirect.com

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.

• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752
  Medicare reassignment NPD
• Akron Children'S Hospital

  • Children's Hospital
  • Akron, OH
  • NPI 1942465752
  NPD
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD
• Charleston Area Medical Center Inc

  • Psychiatric Hospital Unit
  • Charleston, WV
  • NPI 1265421226
  NPD (past)
• Children'S Hospital Medical Center of Akron

  • Home Infusion Agency
  • Akron, OH
  • NPI 1649485848
  NPD (past)
• Children'S Hospital Medical Center of Akron

  • Pediatrics Physician
  • Akron, OH
  • NPI 1841328853
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982
  NPD (past)

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1053671669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 GEORGE ST STE 2",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012620",
            "telephone_number": "304-255-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 GEORGE ST STE 2",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012620",
            "telephone_number": "304-255-2878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6505 Market St Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Boardman",
            "state": "OH",
            "postal_code": "445123457",
            "country_code": "US",
            "telephone_number": "330-746-8040",
            "fax_number": "330-746-8025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICKLITER",
        "first_name": "JACQUELINE",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-17",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "2950",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.012256",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053671669",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlickliter16687@direct.chmca.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6505 Market St Ste 2100",
            "city": "Boardman",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445123457",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacqueline.lickliter@camc.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "230 George St Ste 2",
            "city": "Beckley",
            "state": "WV",
            "country_code": "US",
            "postal_code": "258012620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristen Lewis
• Melissa S Lewis, LICSW
• Sierra J Lewis
• Jie Li, CRNA
• Liberty Dental Centers
• Life Strategies Counseling Services Inc.
• Lifechangers Family Services LLC
• Jenny Lynn Lilley
• Ann Mills Lilly, MSN
• April Lynn Lilly, PNP-BC

• Pediatrics Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Pediatrics Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.