Cheron Marcell Puryear, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

5078 Williamsport Pike Ste I
Martinsburg, WV 25404-6458

Phone

(304) 271-8895

Fax

(304) 271-8891

NPI assigned

Nov 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: cheron.puryear.p1@direct.winc-ortho.nextgenshare.com

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.

• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1457389595
  NPD (past)

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

{
    "created_epoch": "1605312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1164024014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5078 WILLIAMSPORT PIKE STE I",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254046458",
            "telephone_number": "304-271-8895",
            "fax_number": "304-271-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURYEAR",
        "first_name": "CHERON",
        "middle_name": "MARCELL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-14",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213941",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5078 Williamsport Pike Ste I",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254046458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heaven Puffenbarger
• Dahlia C Pugh, MSW
• Elizabeth Puller
• Pulmonary Associates, Incorporated
• Brandy D Pulse
• Elizabeth L Putnam, PA-C
• Victoria A. Pyles, NNP-BC
• Kaylah Faith Qassis
• Quad/Med, LLC
• William F. Queen, DDS

• Physical Therapist in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.

Verify at the official NPI Registry.