Individual provider Active NPI

Dorethea L Taylor-Henshaw, RN

  • Inpatient Obstetric Registered Nurse
  • South Charleston, WV
National Provider Identifier
1487443750
Registry record updated May 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Inpatient Obstetric Registered NurseTaxonomy code 163WX0003X
License
111971 Issued in WV
Practice address
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone
(304) 766-3971
NPI assigned
May 3, 2025
Last updated
May 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Obstetric Registered Nurse 163WX0003X 111971 WV Primary

Addresses

Primary practice location

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Mailing address

118 Litchfield LN
Hurricane, WV 25526-8851
Phone (304) 941-9590

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
111971WVMDInpatient Obstetric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1746230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746230400000",
    "number": "1487443750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 LITCHFIELD LN",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268851",
            "telephone_number": "304-941-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-766-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR-HENSHAW",
        "first_name": "DORETHEA",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-03",
        "last_updated": "2025-05-03",
        "certification_date": "2025-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "WV",
            "license": "111971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.