Issaiah Wallace, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

102650 Issued in WV

Practice address

936 Sharpe Hospital Rd
Weston, WV 26452-8550

Phone

(304) 269-1210

NPI assigned

May 16, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

William R Sharpe Jr HospitalGroup PAC ID 8224949383, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• William R. Sharpe, Jr. Hospital

  • Psychiatric Hospital
  • Weston, WV
  • NPI 1770581118
  Medicare reassignment Care Compare group NPD
• Valley Comprehensive Community Mental Health Center, Inc.

  • Mental Health Counselor
  • Morgantown, WV
  • NPI 1861476350
  Medicare reassignment NPD
• William R Sharpe Jr Hospital

  • Clinical Neuropsychologist
  • Weston, WV
  • NPI 1659772598
  NPD
• Valley Comprehensive Community Mental Health Center

  • Community/Behavioral Health Agency
  • Morgantown, WV
  • NPI 1154740660
  NPD (past)

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1508422338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "ENTERPRISE",
            "state": "WV",
            "postal_code": "265680012",
            "telephone_number": "304-709-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 SHARPE HOSPITAL RD",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264528550",
            "telephone_number": "304-269-1210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132 William Ln",
            "address_purpose": "LOCATION",
            "city": "Mount Clare",
            "state": "WV",
            "postal_code": "264087227",
            "country_code": "US",
            "telephone_number": "304-712-4358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ISSAIAH",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-16",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "102650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Dawn Vanpelt, PHARMD
• Carmen Wakeland
• Wal-Mart Stores East LP
• Walgreen Co
• Amber Wallace
• Sharie Waller
• Roberta Walls
• Kaitlyn Ware
• Tammy Jean Ware
• Briana Warner

• Psychiatric/Mental Health Nurse Practitioner in Weston, WV
• Providers in Weston, WV by specialty
• Psychiatric/Mental Health Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.