Individual provider Active NPI

Joe Farris, MD

  • Internal Medicine Physician
  • Charleston, WV
National Provider Identifier
1144299728
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13126 Issued in WV
Practice address
2114 Presidential Dr
Charleston, WV 25314-2369
Phone
(304) 346-7701
Fax
(304) 388-9743
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13126 WV Primary

Addresses

Primary practice location

2114 Presidential Dr
Charleston, WV 25314-2369

Mailing address

2114 Presidential Dr
Charleston, WV 25314-2369
Phone (304) 346-7701

Other identifiers 1

IdentifierTypeStateIssuer
0084084000MedicaidWV

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
I20051021000323 WV Practitioner - Internal Medicine 2769408426 Practice locations: Charleston, WV

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13126WVMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1144299728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 PRESIDENTIAL DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142369",
            "telephone_number": "304-346-7701",
            "fax_number": "304-388-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 PRESIDENTIAL DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142369",
            "telephone_number": "304-346-7701",
            "fax_number": "304-388-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "JOE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "13126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084084000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.