Active NPI
Tessa Rae Cavins
- Pharmacist
- Vienna, WV
National Provider Identifier
1427655323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0012152
- Practice address
- 2300 Grand Central Ave
Vienna, WV 26105-1347 - Phone
- (304) 295-4573
- Fax
- (304) 295-0639
- NPI assigned
- Oct 4, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP0012152 | WV | Primary |
Addresses
Primary practice location
2300 Grand Central Ave
Vienna, WV 26105-1347
Mailing address
2300 Grand Central Ave
Vienna, WV 26105-1347
Phone (304) 295-4573
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 |
|---|---|---|---|
| RP0012152 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710201600000",
"number": "1427655323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 GRAND CENTRAL AVE",
"city": "VIENNA",
"state": "WV",
"postal_code": "261051347",
"telephone_number": "304-295-4573",
"fax_number": "304-295-0639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 GRAND CENTRAL AVE",
"city": "VIENNA",
"state": "WV",
"postal_code": "261051347",
"telephone_number": "304-295-4573",
"fax_number": "304-295-0639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVINS",
"first_name": "TESSA",
"middle_name": "RAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-04",
"last_updated": "2024-03-12",
"certification_date": "2024-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0012152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.