Individual provider Active NPI

Nicholas Andrew Wallman

  • Day Training/Habilitation Specialist
  • Morgantown, WV
National Provider Identifier
1225625635
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
Practice address
5000 Greenbag Rd
Morgantown, WV 26501-7163
Phone
(304) 554-2200
NPI assigned
Dec 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X Primary

Addresses

Primary practice location

5000 Greenbag Rd
Morgantown, WV 26501-7163

Mailing address

301 Scott Ave
Morgantown, WV 26508-8804
Phone (304) 296-1731

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": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1225625635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SCOTT AVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265088804",
            "telephone_number": "304-296-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 GREENBAG RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265017163",
            "telephone_number": "304-554-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLMAN",
        "first_name": "NICHOLAS",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.