Active NPI
Robert Hysell
- Peer Specialist
- Kenova, WV
National Provider Identifier
1407679079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 24-9128
- Practice address
- 802 Oak St
Kenova, WV 25530-1519 - Phone
- (304) 908-1056
- NPI assigned
- Nov 4, 2024
- Last updated
- Nov 4, 2024
- 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 | 24-9128 | WV | Primary |
Addresses
Primary practice location
802 Oak St
Kenova, WV 25530-1519
Mailing address
802 Oak St
Kenova, WV 25530-1519
Phone (304) 908-1056
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 |
|---|---|---|---|
| 24-9128 | WV | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1407679079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 OAK ST",
"city": "KENOVA",
"state": "WV",
"postal_code": "255301519",
"telephone_number": "304-908-1056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 OAK ST",
"city": "KENOVA",
"state": "WV",
"postal_code": "255301519",
"telephone_number": "304-908-1056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HYSELL",
"first_name": "ROBERT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-04",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WV",
"license": "24-9128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenova, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.