Organization Active NPI

Misti Jones Wheeler Ms Inc.

  • Clinical Psychologist
  • Beckley, WV
National Provider Identifier
1174741607
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
828 Issued in WV
Legal business name
MISTI JONES WHEELER MS INC.
Practice address
805 Johnstown Rd
Beckley, WV 25801-4935
Phone
(304) 929-3945
Fax
(304) 929-3945
NPI assigned
Apr 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Misti Dawn Jones- Wheeler, M.S.NPI 1356440390
Title
Owner
Phone
(304) 929-3945

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 828 WV Primary

Addresses

Primary practice location

805 Johnstown Rd
Beckley, WV 25801-4935

Mailing address

214 Woodlawn Ave
Beckley, WV 25801-5407
Phone (304) 575-6718

Other identifiers 1

IdentifierTypeStateIssuer
3810002103MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080925000378 WV Part B Supplier - Clinic/Group Practice 7618044116 Receives reassigned benefits from 1 practitioner
Practice locations: Beckley, WV

National Provider Directory

National Provider Directory

Locations

805 Johnstown Rd
Beckley, WV 25801
Phone (304) 929-3945

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174741607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 WOODLAWN AVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258015407",
            "telephone_number": "304-575-6718",
            "fax_number": "304-929-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 JOHNSTOWN RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014935",
            "telephone_number": "304-929-3945",
            "fax_number": "304-929-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISTI JONES WHEELER MS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES- WHEELER",
        "authorized_official_first_name": "MISTI",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-929-3945",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002103",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.