Individual provider Active NPI

Elizabeth Marilynn Feltner, DPM

  • Podiatrist
  • Kenova, WV
National Provider Identifier
1174611818
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00375 Issued in WV
Practice address
1102 Poplar Street
Kenova, WV 25530
Phone
(304) 453-5458
Fax
(304) 453-5459
NPI assigned
Oct 10, 2006
Last updated
May 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Podiatrist 213E00000X 00375 WV Primary
Podiatrist 213E00000X 314 KY

Addresses

Primary practice location

1102 Poplar Street
Kenova, WV 25530

Mailing address

PO Box 183
Kenova, WV 25530
Phone (304) 453-5458

Other identifiers 2

IdentifierTypeStateIssuer
2102034000MedicaidWV
4907030001OtherDME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110606000284 TX Practitioner - Podiatry 5890785836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.07 of 100Reported as group
Quality
73.06
Improvement activities
40
Cost
69.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
375WVMDRegistered Dietitian
314KYMDPodiatrist
00375WVMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Apr 17, 2011 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Apr 17, 2011 Accepting new patients
Patrick J Nunan DPM PLLC Podiatrist Past Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241568000000",
    "number": "1174611818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 183",
            "city": "KENOVA",
            "state": "WV",
            "postal_code": "25530",
            "telephone_number": "304-453-5458",
            "fax_number": "304-453-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 POPLAR STREET",
            "city": "KENOVA",
            "state": "WV",
            "postal_code": "25530",
            "telephone_number": "304-453-5458",
            "fax_number": "304-453-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELTNER",
        "first_name": "ELIZABETH",
        "middle_name": "MARILYNN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WV",
            "license": "00375",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KY",
            "license": "314",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2102034000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "4907030001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenova, WV

Sources for this page

Verify at the official NPI Registry.