Active NPI
Charles Edward McPherson
- Occupational Therapy Assistant
- Vienna, WV
National Provider Identifier
1124711486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- C1336
- Practice address
- 2200 Grand Central Ave
Vienna, WV 26105-1300 - Phone
- (304) 428-2554
- NPI assigned
- Jun 1, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | C1336 | WV | Primary |
Addresses
Primary practice location
2200 Grand Central Ave
Vienna, WV 26105-1300
Mailing address
678 Old Seven Rd
Coolville, OH 45723-9778
Phone (740) 236-3908
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1336 | WV | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1124711486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "678 OLD SEVEN RD",
"city": "COOLVILLE",
"state": "OH",
"postal_code": "457239778",
"telephone_number": "740-236-3908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 GRAND CENTRAL AVE",
"city": "VIENNA",
"state": "WV",
"postal_code": "261051300",
"telephone_number": "304-428-2554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCPHERSON",
"first_name": "CHARLES",
"middle_name": "EDWARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-01",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WV",
"license": "C1336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.