Individual provider Active NPI

Sommer Beane

  • Medical Physician Assistant
  • Charleston, WV
National Provider Identifier
1295485571
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
600 Tracy Way Ste 2
Charleston, WV 25311-1262
Phone
(304) 346-8877
NPI assigned
Mar 28, 2022
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

600 Tracy Way Ste 2
Charleston, WV 25311-1262

Mailing address

501 Morris St
Charleston, WV 25301-1326
Phone (304) 647-6006

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125000307 WV Practitioner - Physician Assistant 3870964182 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
WV Asthma and Allergy Centers, Inc. CurrentSince Dec 6, 2022 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Aug 7, 2023 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Aug 7, 2023 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

208 Maccorkle Ave SE
Charleston, WV 25314
Phone (304) 343-4300

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

600 Tracy Way
Ste 2
Charleston, WV 25311
Phone (304) 346-8877

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1295485571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-647-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 TRACY WAY STE 2",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111262",
            "telephone_number": "304-346-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEANE",
        "first_name": "SOMMER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.