Makenzie Nichole Hale

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

150 Maple St
402
Sophia, WV 25921

Phone

(304) 994-0203

NPI assigned

Dec 11, 2020

Last updated

Dec 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1073119277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "SOPHIA",
            "state": "WV",
            "postal_code": "259211449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MAPLE ST",
            "address_2": "402",
            "city": "SOPHIA",
            "state": "WV",
            "postal_code": "25921",
            "telephone_number": "304-994-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "MAKENZIE",
        "middle_name": "NICHOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00301466781",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Work",
            "affiliation": "N",
            "address_1": "150 maple st",
            "address_2": "402",
            "city": "Sophia",
            "state": "WV",
            "country_code": "US",
            "postal_code": "25921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lori Flis, CNP
• Trista L. Gibson, PA-C
• Michael D Green, PA-C
• Amber Gunter
• Mitzi Jane Haga
• Rebecca Louise Harris
• Brenda Hix
• Michael Shane Horton, MSW
• Gina Maria Howerton
• Vanessa K Hughes

• Personal Care Attendant in Sophia, WV
• Providers in Sophia, WV by specialty
• Personal Care Attendant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.