Active NPI
Mervan Newbold, PHARMD
- Psychiatric Pharmacist
- Clarksburg, WV
National Provider Identifier
1255817060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- P8067
- Practice address
- 1 Med Center Dr
Clarksburg, WV 26301-4155 - Phone
- (304) 623-3461
- NPI assigned
- Jul 15, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P8067 | ID | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | P8067 | ID | |
| Psychiatric Pharmacist | 1835P1300X | P8067 | ID | Primary |
Addresses
Primary practice location
1 Med Center Dr
Clarksburg, WV 26301-4155
Mailing address
1 Medical Center Dr
Clarksburg, WV 26301
Phone (304) 326-7873
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P8067 | ID | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1255817060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "26301",
"telephone_number": "304-326-7873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MED CENTER DR",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "263014155",
"telephone_number": "304-623-3461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBOLD",
"first_name": "MERVAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-15",
"last_updated": "2024-04-19",
"certification_date": "2024-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P8067",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "ID",
"license": "P8067",
"primary": false
},
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "ID",
"license": "P8067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.