Brandon Adams
Individual provider Active NPI Community Health Worker · Genoa, WV
NPI 1124607114 · NPPES record last updated Apr 6, 2021
Key facts
- NPI
- 1124607114
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 2459 Big Lynn CK Rd
Genoa, WV 25512 - Phone
- (304) 563-2644
- NPI assigned
- Apr 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
2459 Big Lynn CK Rd
Genoa, WV 25512
Mailing address
PO Box 342
East Lynn, WV 25512-0342
Other providers in Genoa, WV
All providers in Genoa, WV · Community Health Worker in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.