Individual provider Active NPI

Jodie Howell, MD

  • Family Medicine Physician
  • Blacksville, WV
National Provider Identifier
1528024288
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21811 Issued in WV
Practice address
5861 Mason-Dixon Highway
Box 72
Blacksville, WV 26521
Phone
(304) 432-8211
Fax
(304) 432-8213
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21811 WV Primary

Addresses

NPPES NPI Registry

Primary practice location

5861 Mason-Dixon Highway
Box 72
Blacksville, WV 26521

Mailing address

5861 Mason-Dixon Highway
Box 72
Blacksville, WV 26521
Phone (304) 432-8211

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
3810004757MedicaidWV
P00401095OtherWVRR MEDICARE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 2, 2008.

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1528024288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5861 MASON-DIXON HIGHWAY",
            "address_2": "BOX 72",
            "city": "BLACKSVILLE",
            "state": "WV",
            "postal_code": "26521",
            "telephone_number": "304-432-8211",
            "fax_number": "304-432-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5861 MASON-DIXON HIGHWAY",
            "address_2": "BOX 72",
            "city": "BLACKSVILLE",
            "state": "WV",
            "postal_code": "26521",
            "telephone_number": "304-432-8211",
            "fax_number": "304-432-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWELL",
        "first_name": "JODIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "21811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004757",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00401095",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.