Mariah Janelle Shultz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2276 Issued in WV

Practice address

1005 White Willow Way
Morgantown, WV 26505-6119

Phone

(304) 460-5123

NPI assigned

Jun 11, 2019

Last updated

May 20, 2024By the provider in NPPES

Sex

Female

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

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Grandw IncGroup PAC ID 9739324922, 93 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• GR&W, Inc

  dba GR&W Harmony

  • Clinical Neuropsychologist
  • Morgantown, WV
  • NPI 1407192024
  Medicare reassignment Care Compare group
• West Virginia Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Morgantown, WV
  • NPI 1952776379
  Medicare reassignment
• GR&W, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morgantown, WV
  • NPI 1992665723
  NPD
• Monongalia County General Hospital Company

  dba Mon Health Medical Center

  • Specialist
  • Morgantown, WV
  • NPI 1447673223
  NPD (past)

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1538728613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 WESTWOOD AVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052236",
            "telephone_number": "724-263-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 WHITE WILLOW WAY",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265056119",
            "telephone_number": "304-460-5123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 J D Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265053486",
            "country_code": "US",
            "telephone_number": "304-598-1200",
            "fax_number": "304-598-8382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "MARIAH",
        "middle_name": "JANELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leanna Shrout
• Breanne Shrum, PTA, CFO
• Maan Abdulrahman Shukr, MBBS
• Kim Shultz-Park
• Heidi Shultz
• Linda I Shuster, CCC/SLP
• Morgan Shutler
• Olivia Lea Shuttleworth, LICSW
• Laurel Shymansky, PA-C
• Georgia Siburt

• Physician Assistant in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.