NPIMap

Individual provider Active NPI

Jeffrey E Wheeler, DPM

  • Podiatrist
  • Cross Lanes, WV
National Provider Identifier
1174562748
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00354 Issued in WV
Practice address
314 Goff Mountain Road Suite 15
Cross Lanes, WV 25313
Phone
(304) 776-7990
Fax
(304) 776-7974
NPI assigned
Jun 6, 2006
Last updated
Jun 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 00354 WV Primary

Addresses

Primary practice location

314 Goff Mountain Road Suite 15
Cross Lanes, WV 25313

Mailing address

314 Goff Mountain Road Suite 15
Cross Lanes, WV 25313
Phone (304) 776-7990

Other identifiers 1

IdentifierTypeStateIssuer
6420033000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100601000089 WV Practitioner - Podiatry 7719016765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Prestige Park Dr
Suite 400B1
Hurricane, WV 25526-8420
Phone (304) 776-7990

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue34
Removal of nail tissue510
Removal or shaving of skin growth111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Foot & Ankle Care, PLLC Podiatrist CurrentSince Sep 1, 2002 Accepting new patients

Locations

314 Goff Mountain Rd
Ste 15
Cross Lanes, WV 25313
Phone (304) 776-7990

400 Prestige Park Dr
Ste 400B1
Hurricane, WV 25526
Phone (304) 776-7990

Organizations & group practices 1

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

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1174562748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 GOFF MOUNTAIN ROAD SUITE 15",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "25313",
            "telephone_number": "304-776-7990",
            "fax_number": "304-776-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 GOFF MOUNTAIN ROAD SUITE 15",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "25313",
            "telephone_number": "304-776-7990",
            "fax_number": "304-776-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "JEFFREY",
        "middle_name": "E",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WV",
            "license": "00354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6420033000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cross Lanes, WV

Sources for this page

Verify at the official NPI Registry.