Brent Champ

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

643 White Fawn Rd
Mathias, WV 26812-8665

Phone

(304) 636-9396

NPI assigned

Feb 22, 2021

Last updated

Jun 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1205420148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 WHITE FAWN RD",
            "city": "MATHIAS",
            "state": "WV",
            "postal_code": "268128665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 WHITE FAWN RD",
            "city": "MATHIAS",
            "state": "WV",
            "postal_code": "268128665",
            "telephone_number": "304-636-9396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMP",
        "first_name": "BRENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kandie Adolphson
• Tracey Ann Casteel
• Arthur J Cerami Jr., PA-C
• Starsha Elizabeth Champ
• E.a. Hawse Health Center Inc. (Hawse Health Center)
• Tiffany Ashlea Fansler, RN
• Joan Foltz
• Angel Foshee

• Personal Care Attendant in Mathias, WV
• Providers in Mathias, WV by specialty
• Personal Care Attendant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.