Jackelyn Sias

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

819 Upper Sand Run Rd
Buckhannon, WV 26201-7099

Phone

(304) 777-7361

NPI assigned

Mar 8, 2021

Sex

Female

Sole proprietor

Yes

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": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1265027684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 UPPER SAND RUN RD",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262017099",
            "telephone_number": "304-777-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 UPPER SAND RUN RD",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262017099",
            "telephone_number": "304-777-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIAS",
        "first_name": "JACKELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Lee Sherman, PA-C
• Andreia Sholes
• Sheryl Short
• Trey Short
• Casey Aaron Shrout, RPH
• Adison Simmons
• Barbara M Simmons
• Franchesca Simmons
• Lynn Simmons
• Connie Kay Sipe

• Community Health Worker in Buckhannon, WV
• Providers in Buckhannon, WV by specialty
• Community Health Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.