Active NPI
Sally Marcellais
- Community Health Worker
- Ravenswood, WV
National Provider Identifier
1396339446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 1104 Ann St
Ravenswood, WV 26164-1002 - Phone
- (304) 440-4000
- NPI assigned
- Mar 1, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
1104 Ann St
Ravenswood, WV 26164-1002
Mailing address
PO Box 952
Ravenswood, WV 26164-0952
Phone (304) 273-9527
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": "1614556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614556800000",
"number": "1396339446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 952",
"city": "RAVENSWOOD",
"state": "WV",
"postal_code": "261640952",
"telephone_number": "304-273-9527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 ANN ST",
"city": "RAVENSWOOD",
"state": "WV",
"postal_code": "261641002",
"telephone_number": "304-440-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCELLAIS",
"first_name": "SALLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-01",
"last_updated": "2021-03-01",
"certification_date": "2021-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ravenswood, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.