Individual provider Active NPI

Sahara J Stanley, PA-C

  • Physician Assistant
  • Charleston, WV
National Provider Identifier
1538702154
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
333 Laidley St
Charleston, WV 25301-1614
Phone
(304) 347-6116
Fax
(304) 347-6117
NPI assigned
Oct 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X VA
Physician Assistant 363A00000X WV Primary

Addresses

Primary practice location

333 Laidley St
Charleston, WV 25301-1614

Mailing address

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Other practice location 1

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221128002126 WV Practitioner - Physician Assistant 9638547557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Hospital & facility affiliations

  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029
  • Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Community Hospital Assn., Inc. CurrentSince Jun 17, 2023 Accepting new patients
Princeton Community Hospital Assn., Inc CurrentSince Jun 17, 2023 Accepting new patients

Locations

401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1538702154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-414-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LAIDLEY ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011614",
            "telephone_number": "304-347-6116",
            "fax_number": "304-347-6117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4605 MACCORKLE AVE SW",
            "address_purpose": "LOCATION",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "country_code": "US",
            "telephone_number": "304-414-4800",
            "fax_number": "304-414-4801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "SAHARA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.