Patrick Jarrell

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3575 Issued in WV

Legal business name

PATRICK JARRELL

Practice address

213 W Maple Ave
Fayetteville, WV 25840-1413

Phone

(304) 574-2833

Fax

(304) 574-2489

NPI assigned

Dec 10, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Patrick D Jarrell, DDSNPI 1780713974

Title

President

Phone

(304) 574-2833

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patrick D. Jarrell, D.D.S.

  • General Practice Dentistry
  • Fayetteville, WV
  • NPI 1780713974

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1154729994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 W MAPLE AVE",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258401413",
            "telephone_number": "304-574-2833",
            "fax_number": "304-574-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W MAPLE AVE",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258401413",
            "telephone_number": "304-574-2833",
            "fax_number": "304-574-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK JARRELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-10",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "JARRELL",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-574-2833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3575",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3932",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233275554",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allie Chinyere Nwosu, MS
• James William Odell
• Heather Rayan Pack, LPC, ALPS, NCC, AADC
• Sharon Pack, P.T.
• Carl Parsons
• Lauren Perez
• Andrew Hunter Petersen, DO
• Karen L. Pettry-Hultman, DO
• Carissa Pierson
• Rachel Pino, COTA/L

• All providers in Fayetteville, WV
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.