NPIMap

Individual provider Active NPI

Marciea Evick, D.D.S.

  • General Practice Dentistry
  • Elkins, WV
National Provider Identifier
1154400380
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3598 Issued in WV
Practice address
600 S Randolph Ave
Elkins, WV 26241-5702
Phone
(304) 636-5800
Fax
(304) 636-0971
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3598 WV Primary

Addresses

Primary practice location

600 S Randolph Ave
Elkins, WV 26241-5702

Mailing address

600 S Randolph Ave
Elkins, WV 26241-5702
Phone (304) 636-5800

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

LicenseStateTypeSpecialty
3598WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Frank L Mams General Practice Past Accepting new patients
Mams and Evick, DDS, PLLC General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154400380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S RANDOLPH AVE",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262415702",
            "telephone_number": "304-636-5800",
            "fax_number": "304-636-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S RANDOLPH AVE",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262415702",
            "telephone_number": "304-636-5800",
            "fax_number": "304-636-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVICK",
        "first_name": "MARCIEA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.