Individual provider Active NPI

Emily Holmes-Hackerd

  • Physician Assistant
  • Morgantown, WV
National Provider Identifier
1154192755
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3223 Issued in WV
Practice address
5000 Domain Dr Apt 1024
Morgantown, WV 26501-2528
Phone
(215) 859-2881
NPI assigned
Jan 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3223 WV Primary

Addresses

Primary practice location

5000 Domain Dr Apt 1024
Morgantown, WV 26501-2528

Mailing address

5000 Domain Dr Apt 1024
Morgantown, WV 26501-2528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Morgantown, WV 26507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1154192755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 DOMAIN DR APT 1024",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265012528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 DOMAIN DR APT 1024",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265012528",
            "telephone_number": "215-859-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES-HACKERD",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "3223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.