Lively Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

LIVELY PEDIATRICS, PLLC

Practice address

466 Courthouse Rd
Princeton, WV 24740-2422

Phone

(304) 913-3160

Fax

(855) 618-2212

NPI assigned

Feb 21, 2021

Last updated

Sep 22, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Mitchell

Title

Office Manager

Phone

(304) 952-2087

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tara Mitchell, D.O.

  • Pediatrics Physician
  • Princeton, WV
  • NPI 1326221888
  Medicare reassignment NPD
• Jennifer Nicole Taylor, FNP-BC

  • Family Nurse Practitioner
  • Spanishburg, WV
  • NPI 1851918494
  Medicare reassignment NPD
• Basim Wadih Antoun, MD

  • Diagnostic Radiology Physician
  • Princeton, WV
  • NPI 1982695276
  NPD
• Wesley L Asbury Jr., MD

  • Diagnostic Radiology Physician
  • Princeton, WV
  • NPI 1619924511
  NPD
• Manuel T. Franco, M.D.

  • Diagnostic Radiology Physician
  • Princeton, WV
  • NPI 1689856387
  NPD
• Michael E Shahan, M.D.

  • Diagnostic Radiology Physician
  • Princeton, WV
  • NPI 1720087612
  NPD
• Afzal U Ahmed, M.D.

  • Diagnostic Radiology Physician
  • Princeton, WV
  • NPI 1427057090
  NPD (past)
• Stephen Matthew Belcher, DO

  • Diagnostic Radiology Physician
  • Princeton, WV
  • NPI 1245495597
  NPD (past)
• Ashley Hope Crook, FNP-C

  • Family Nurse Practitioner
  • Princeton, WV
  • NPI 1346093234
  NPD (past)
• David L. Groten, M.D.

  • Vascular & Interventional Radiology Physician
  • Princeton, WV
  • NPI 1932108180
  NPD (past)
• Wendy Kaye Lawless, FNP-C

  • Family Nurse Practitioner
  • Bluefield, WV
  • NPI 1073149407
  NPD (past)
• Dana O Olson, M.D.

  • Diagnostic Radiology Physician
  • Princeton, WV
  • NPI 1356340400
  NPD (past)

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

{
    "created_epoch": "1613865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1063006047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 COURTHOUSE RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402422",
            "telephone_number": "304-913-3160",
            "fax_number": "855-618-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 COURTHOUSE RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402422",
            "telephone_number": "304-913-3160",
            "fax_number": "855-618-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVELY PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-21",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-952-2087"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lincare Inc
• Brandon M Lingenfelter, DO
• Megan Lingenfelter, PA-C
• Patricia Afton Linkous, RN
• Staci Lyn Linkous, PA-C
• Kimberly Lively, BS
• Marvin Lockett, RBA
• Blake Joseph Loftis
• Nancy Ann Lohuis, M.D.
• Marshall C Long, DO

• Pediatrics Physician in Princeton, WV
• Providers in Princeton, 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 Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.