Individual provider Active NPI

Jodi L. Law, CFNP

  • Family Nurse Practitioner
  • Vienna, WV
National Provider Identifier
1366445843
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
63591 Issued in WV
Practice address
1601 Grand Central Ave Ste 5
Vienna, WV 26105-1082
Phone
(304) 422-5600
Fax
(304) 422-5993
NPI assigned
May 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 63591 WV Primary

Addresses

Primary practice location

1601 Grand Central Ave Ste 5
Vienna, WV 26105-1082

Mailing address

1601 Grand Central Ave Ste 5
Vienna, WV 26105-1082
Phone (304) 422-5600

Other practice location 1

1500 Grand Central Ave Ste 115
Vienna, WV 26105-1079
Phone (304) 485-3627

Other identifiers 1

IdentifierTypeStateIssuer
1366445843MedicaidWV

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
I20050112000486 WV Practitioner - Nurse Practitioner 5799733176 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jodi.law@mmhs.medicity.net

Organizations & group practices 1

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1366445843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 GRAND CENTRAL AVE STE 5",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051082",
            "telephone_number": "304-422-5600",
            "fax_number": "304-422-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 GRAND CENTRAL AVE STE 5",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051082",
            "telephone_number": "304-422-5600",
            "fax_number": "304-422-5993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Grand Central Ave Ste 115",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "WV",
            "postal_code": "261051079",
            "country_code": "US",
            "telephone_number": "304-485-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAW",
        "first_name": "JODI",
        "middle_name": "L.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "63591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366445843",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, WV

Sources for this page

Verify at the official NPI Registry.