Individual provider Active NPI

Mariah Felty

  • Community Health Worker
  • Charleston, WV
National Provider Identifier
1205563897
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1816 Pennsylvania Ave Apt C
Charleston, WV 25302-4130
Phone
(304) 382-3964
NPI assigned
Aug 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

1816 Pennsylvania Ave Apt C
Charleston, WV 25302-4130

Mailing address

1816 Pennsylvania Ave Apt C
Charleston, WV 25302-4130
Phone (304) 382-3964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1205563897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 PENNSYLVANIA AVE APT C",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253024130",
            "telephone_number": "304-382-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 PENNSYLVANIA AVE APT C",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253024130",
            "telephone_number": "304-382-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELTY",
        "first_name": "MARIAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.