Active NPI
Timothy Dean Stafford
- Homemaker
- Williamsburg, WV
National Provider Identifier
1225752637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 9344 Shoestring TRL
Williamsburg, WV 24991-0141 - Phone
- (304) 661-2336
- NPI assigned
- Sep 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | EMP4738 | WV | |
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
9344 Shoestring TRL
Williamsburg, WV 24991-0141
Mailing address
PO Box 141
Williamsburg, WV 24991-0141
Phone (304) 667-6678
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| EMP4738 | WV | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1225752637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 141",
"city": "WILLIAMSBURG",
"state": "WV",
"postal_code": "249910141",
"telephone_number": "304-667-6678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9344 SHOESTRING TRL",
"city": "WILLIAMSBURG",
"state": "WV",
"postal_code": "249910141",
"telephone_number": "304-661-2336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAFFORD",
"first_name": "TIMOTHY",
"middle_name": "DEAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-29",
"last_updated": "2022-10-06",
"certification_date": "2022-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "WV",
"license": "EMP4738",
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.