Individual provider Active NPI

Edward A Jones, MA

  • Counseling Psychologist
  • Lewisburg, WV
National Provider Identifier
1275568552
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
827 Issued in WV
Practice address
1464 Jefferson St N
Lewisburg, WV 24901-1380
Phone
(304) 645-3220
Fax
(844) 479-4545
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 827 WV Primary

Addresses

Primary practice location

1464 Jefferson St N
Lewisburg, WV 24901-1380

Mailing address

1464 Jefferson St N
Lewisburg, WV 24901-1380
Phone (304) 645-3220

Other identifiers 1

IdentifierTypeStateIssuer
3810003722MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825000408 WV Practitioner - Clinical Psychologist 4082688999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Virginia School of Osteopathic Medicine Clinic IncGroup PAC ID 0941113427, shared by 2 NPIs, 33 clinicians

Practice addresses (Care Compare)

1464 Jefferson St N
Lewisburg, WV 24901-1380
Phone (304) 645-3220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia School of Osteopathic Medicine Clinic Inc CurrentSince Jun 19, 2021 Accepting new patients
West Virginia School of Osteopathic Medicine Clinic Inc D/B/a Robert C. Byrd Clinic CurrentSince Nov 24, 2014 Accepting new patients
Appalachian Psychiatric Services PLLC PastSince Sep 1, 2016 Accepting new patients

Locations

1464 Jefferson St N
Lewisburg, WV 24901
Phone (304) 647-5577

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1275568552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1464 JEFFERSON ST N",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011380",
            "telephone_number": "304-645-3220",
            "fax_number": "844-479-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1464 JEFFERSON ST N",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011380",
            "telephone_number": "304-645-3220",
            "fax_number": "844-479-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WV",
            "license": "827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003722",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

Verify at the official NPI Registry.