Individual provider Active NPI

Corey Blake Nahodil

  • Peer Specialist
  • Huntington, WV
National Provider Identifier
1083394555
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
630 8TH Ave
Huntington, WV 25701-2633
Phone
(304) 962-8822
NPI assigned
Jul 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

630 8TH Ave
Huntington, WV 25701-2633

Mailing address

1104 26TH St
Huntington, WV 25705-1110
Phone (681) 268-4051

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": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1083394555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 26TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257051110",
            "telephone_number": "681-268-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 8TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012633",
            "telephone_number": "304-962-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAHODIL",
        "first_name": "COREY",
        "middle_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.