Individual provider Active NPI

Josalyn Marie Mann, D.O.

  • Family Medicine Physician
  • Bridgeport, WV
National Provider Identifier
1093929424
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2239 Issued in WV
Practice address
1511 Johnson Ave
Ste 104
Bridgeport, WV 26330-1016
Phone
(304) 848-0702
Fax
(304) 848-0705
NPI assigned
May 8, 2007
Last updated
Apr 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58.001640 OH
Family Medicine Physician 207Q00000X 2239 WV Primary

Addresses

Primary practice location

1511 Johnson Ave
Ste 104
Bridgeport, WV 26330-1016

Mailing address

686 South Pike St
Ste a
Shinnston, WV 26431-1043
Phone (304) 624-4655

Other identifiers 1

IdentifierTypeStateIssuer
3810009403MedicaidWV

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jmann7911@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address jmann7911@direct.wvuhsdirect.com Health Information Exchange (HIE)

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070730000208 WV Practitioner - Family Practice 0648371005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Physicians Care IncGroup PAC ID 6103814017, 119 clinicians

Practice addresses (Care Compare)

1511 Johnson Ave
Suite 104
Bridgeport, WV 26330-1016
Phone (681) 342-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
58.001640OHMDFamily Medicine Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1093929424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 SOUTH PIKE ST",
            "address_2": "STE A",
            "city": "SHINNSTON",
            "state": "WV",
            "postal_code": "264311043",
            "telephone_number": "304-624-4655",
            "fax_number": "304-624-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 JOHNSON AVE",
            "address_2": "STE 104",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301016",
            "telephone_number": "304-848-0702",
            "fax_number": "304-848-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "JOSALYN",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "58.001640",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "2239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009403",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmann7911@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1511 Johnson Ave Ste 104",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263301016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmann7911@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1511 Johnson Ave",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263301016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.