Active NPI
Austin Tyler Wright, D.D.S.
- Dentist
- Beckley, WV
National Provider Identifier
1053792705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4158
- Practice address
- 411 Carriage Dr
Beckley, WV 25801-2805 - Phone
- (304) 252-4897
- Fax
- (304) 252-2892
- NPI assigned
- Jun 17, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4158 | WV | Primary |
Addresses
Primary practice location
411 Carriage Dr
Beckley, WV 25801-2805
Mailing address
PO Box 439
Bolt, WV 25817-0439
Phone (304) 573-6767
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160531002090 | WV | Order and Referring Only - Oral Surgery | 8123318342 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4158 | WV | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434499200000",
"number": "1053792705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 439",
"city": "BOLT",
"state": "WV",
"postal_code": "258170439",
"telephone_number": "304-573-6767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 CARRIAGE DR",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258012805",
"telephone_number": "304-252-4897",
"fax_number": "304-252-2892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "AUSTIN",
"middle_name": "TYLER",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-17",
"last_updated": "2015-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "4158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.