Individual provider Active NPI

Jessica Dawn Talley

  • Child & Adolescent Psychiatry Physician
  • Charleston, WV
National Provider Identifier
1548453723
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
26182 Issued in WV
Practice address
3200 Maccorkle Ave SE FL 5
Charleston, WV 25304-1227
Phone
(304) 388-1000
Fax
(304) 388-1041
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X MD436332 PA
Child & Adolescent Psychiatry Physician 2084P0804X 26182 WV Primary

Addresses

Primary practice location

3200 Maccorkle Ave SE FL 5
Charleston, WV 25304-1227

Mailing address

3200 Maccorkle Ave SE FL 5
Charleston, WV 25304-1227
Phone (304) 388-1000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jtalley40447@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address jtalley40447@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141218001275 WV Practitioner - Psychiatry 7517043235 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26182WVMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince May 4, 2022 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince May 4, 2022 Accepting new patients

Locations

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

3200 Maccorkle Ave SE
#C
Charleston, WV 25304
Phone (304) 347-1336

3200 Maccorkle Ave SE
Fl 5
Charleston, WV 25304
Phone (304) 388-1000

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1548453723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE FL 5",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-1000",
            "fax_number": "304-388-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE FL 5",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-1000",
            "fax_number": "304-388-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "JESSICA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD436332",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WV",
            "license": "26182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtalley40447@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 MacCorkle Ave SE",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253041227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtalley40447@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 MacCorkle Ave SE",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253041227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.