Individual provider Active NPI

Teresita P Dejosef, M.D.

  • General Practice Physician
  • Saint Marys, WV
National Provider Identifier
1164410247
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
12410 Issued in WV
Practice address
111 Lafayette St
Suite 201
Saint Marys, WV 26170-1059
Phone
(304) 684-9409
Fax
(304) 684-2440
NPI assigned
Oct 12, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 12410 WV Primary

Addresses

Primary practice location

111 Lafayette St
Suite 201
Saint Marys, WV 26170-1059

Mailing address

111 Lafayette St
Suite 201
Saint Marys, WV 26170-1059
Phone (304) 684-9409

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1241WVMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164410247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LAFAYETTE ST",
            "address_2": "SUITE 201",
            "city": "SAINT MARYS",
            "state": "WV",
            "postal_code": "261701059",
            "telephone_number": "304-684-9409",
            "fax_number": "304-684-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LAFAYETTE ST",
            "address_2": "SUITE 201",
            "city": "SAINT MARYS",
            "state": "WV",
            "postal_code": "261701059",
            "telephone_number": "304-684-9409",
            "fax_number": "304-684-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJOSEF",
        "first_name": "TERESITA",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WV",
            "license": "12410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.