Individual provider Active NPI

Nevine Estaphan, MD

  • Child & Adolescent Psychiatry Physician
  • Morgantown, WV
National Provider Identifier
1447663034
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
27825 Issued in WV
Practice address
930 Chestnut Ridge Rd
Morgantown, WV 26505-2807
Phone
(304) 598-4214
NPI assigned
Jun 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 27825 WV
Student in an Organized Health Care Education/Training Program 390200000X
Child & Adolescent Psychiatry Physician 2084P0804X 27825 WV Primary

Addresses

Primary practice location

930 Chestnut Ridge Rd
Morgantown, WV 26505-2807

Mailing address

930 Chestnut Ridge Rd
Morgantown, WV 26505-2807
Phone (304) 598-4214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210520002153 PA Practitioner - Psychiatry 2365745569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27825WVMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Life Center Corp CurrentSince Jul 1, 2021 Accepting new patients
Mercy Life Center Corporation Current Accepting new patients

Locations

1200 Reedsdale St
Pittsburgh, PA 15233
Phone (412) 323-4543

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1447663034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 CHESTNUT RIDGE RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052807",
            "telephone_number": "304-598-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 CHESTNUT RIDGE RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052807",
            "telephone_number": "304-598-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTAPHAN",
        "first_name": "NEVINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "27825",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WV",
            "license": "27825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.