Individual provider Active NPI

Letea Marie McAvena, QMHS3

  • Case Manager/Care Coordinator
  • Gallipolis, OH
National Provider Identifier
1073178307
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
3086 State Route 160
Gallipolis, OH 45631-8409
Phone
(740) 446-5500
Fax
(740) 446-4951
NPI assigned
May 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

3086 State Route 160
Gallipolis, OH 45631-8409

Mailing address

PO Box 188
Chillicothe, OH 45601-0188
Phone (740) 773-4366

Other names 1

  • Letea Marie Davis Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1073178307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456010188",
            "telephone_number": "740-773-4366",
            "fax_number": "740-775-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3086 STATE ROUTE 160",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456318409",
            "telephone_number": "740-446-5500",
            "fax_number": "740-446-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCAVENA",
        "first_name": "LETEA",
        "middle_name": "MARIE",
        "credential": "QMHS3",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETEA",
            "last_name": "DAVIS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gallipolis, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.