Individual provider Active NPI

Travis Marcum

  • Community Health Worker
  • Oceana, WV
National Provider Identifier
1376122002
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
39 Rolling Meadows Rd
Oceana, WV 24870-9647
Phone
(304) 837-6004
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

39 Rolling Meadows Rd
Oceana, WV 24870-9647

Mailing address

39 Rolling Meadows Rd
Oceana, WV 24870-9647
Phone (304) 837-6004

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

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1376122002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 ROLLING MEADOWS RD",
            "city": "OCEANA",
            "state": "WV",
            "postal_code": "248709647",
            "telephone_number": "304-837-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 ROLLING MEADOWS RD",
            "city": "OCEANA",
            "state": "WV",
            "postal_code": "248709647",
            "telephone_number": "304-837-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUM",
        "first_name": "TRAVIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceana, WV

Sources for this page

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