Active NPI
Jonathan Pearson
- Child & Adolescent Psychiatric/Mental Health Registered Nurse
- Barboursville, WV
National Provider Identifier
1417583352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatric/Mental Health Registered Nurse
- License
- 91665
- Practice address
- 1535 Martha Rd
Barboursville, WV 25504-9620 - Phone
- (304) 736-0915
- NPI assigned
- Mar 22, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | 91665 | WV | Primary |
Addresses
Primary practice location
1535 Martha Rd
Barboursville, WV 25504-9620
Mailing address
212 Iroquois TRL
Ona, WV 25545-9741
Phone (304) 593-0088
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 |
|---|---|---|---|
| 91665 | WV | MD | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584835200000",
"number": "1417583352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 IROQUOIS TRL",
"city": "ONA",
"state": "WV",
"postal_code": "255459741",
"telephone_number": "304-593-0088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1535 MARTHA RD",
"city": "BARBOURSVILLE",
"state": "WV",
"postal_code": "255049620",
"telephone_number": "304-736-0915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-22",
"last_updated": "2020-03-22",
"certification_date": "2020-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0807X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
"state": "WV",
"license": "91665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barboursville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.