NPIMap

Individual provider Active NPI

Brian Paul Showalter, PA-C

  • Surgical Physician Assistant
  • Marietta, OH
National Provider Identifier
1174828487
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.003230RX Issued in OH
Practice address
400 Matthew St Ste 101
Marietta, OH 45750-1656
Phone
(740) 568-4150
Fax
(740) 568-4151
NPI assigned
Jan 18, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 01536 WV
Surgical Physician Assistant 363AS0400X 50.003230RX OH Primary

Addresses

Primary practice location

400 Matthew St Ste 101
Marietta, OH 45750-1656

Mailing address

416 Colegate Dr BLDG 3
Marietta, OH 45750-9549
Phone (740) 568-4814

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.showalter1@mmhs.medicity

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110309000953 WV Practitioner - Physician Assistant 9830371061 Reassigns benefits to 1 organization
I20110310000010 OH Practitioner - Physician Assistant 9830371061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Memorial HospitalGroup PAC ID 8224928965, 387 clinicians

Practice addresses (Care Compare)

1106 Colegate Dr
Marietta, OH 45750-1323
Phone (740) 568-2000

400 Matthew St
Marietta, OH 45750-1656

401 Matthew St
Marietta, OH 45750-1635
Phone (740) 374-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1536WVMDSpeech-Language Pathologist
01536WVMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Hospitals, Inc CurrentSince Jan 14, 2019 Accepting new patients
Selby General Hospital CurrentSince Jan 1, 2026 Accepting new patients
Marietta Memorial Hospital CurrentSince Jan 30, 2021 Accepting new patients
Selby General Hospital CurrentSince Jan 1, 2026 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients
Marietta Memorial Hospital Past Accepting new patients

Locations

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

1106 Colegate Dr
Marietta, OH 45750
Phone (740) 374-7700

416 Colegate Dr
#3
Marietta, OH 45750
Phone (740) 236-9047

400 Matthew St
Ste 101
Marietta, OH 45750
Phone (740) 568-4150

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

Interoperability endpoints

  • Direct secure messaging: brian.showalter@mmhs.medicity.net

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1174828487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 COLEGATE DR BLDG 3",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457509549",
            "telephone_number": "740-568-4814",
            "fax_number": "740-374-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MATTHEW ST STE 101",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501656",
            "telephone_number": "740-568-4150",
            "fax_number": "740-568-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWALTER",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-18",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "01536",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.003230RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.showalter1@mmhs.medicity",
            "affiliation": "N",
            "address_1": "400 Matthew St Ste 101",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.