Active NPI
Noah Dwayne Bennett
- Peer Specialist
- Huntington, WV
National Provider Identifier
1336084300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 26-946SUD
- Practice address
- 632 30TH St
Huntington, WV 25702-1713 - Phone
- (304) 730-0089
- NPI assigned
- Apr 23, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 26-946SUD | WV | Primary |
Addresses
Primary practice location
632 30TH St
Huntington, WV 25702-1713
Mailing address
632 30TH St
Huntington, WV 25702-1713
Phone (304) 730-0089
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 |
|---|---|---|---|
| 26-946SUD | WV | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776902400000",
"number": "1336084300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "632 30TH ST",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257021713",
"telephone_number": "304-730-0089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "632 30TH ST",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257021713",
"telephone_number": "304-730-0089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "NOAH",
"middle_name": "DWAYNE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-23",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WV",
"license": "26-946SUD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.