Jacob Redden

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4280 Issued in WV

Practice address

252 Rural Acres Dr
Beckley, WV 25801-3503

Phone

(304) 252-8324

NPI assigned

Jun 14, 2022

Last updated

Apr 30, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

West Virginia School of Osteopathic Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tug River Health Association, IncGroup PAC ID 7214820547, shared by 6 NPIs, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046
• Welch Community Hospital Hospital, Welch, WV, CCN 510086

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jacob.redden.1@14333.direct.athenahealth.com
• Direct secure messaging: jacob.redden.1@18068.direct.athenahealth.com

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.

• Tug River Health Association, Inc

  • Federally Qualified Health Center (FQHC)
  • Gary, WV
  • NPI 1174501068
  Medicare reassignment NPD (past)
• Tug River Health Association, Inc

  dba Tug River Health Association

  • Federally Qualified Health Center (FQHC)
  • Princeton, WV
  • NPI 1639842818
  Medicare reassignment
• Tug River Health Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bradshaw, WV
  • NPI 1295033009
  Medicare reassignment

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

• Princeton Community Hospital Assn., Inc.

  • General Acute Care Hospital
  • Princeton, WV
  • NPI 1558313213
  Care Compare affiliation
• State of West Virginia Welch Community Hospital

  • General Acute Care Hospital
  • Welch, WV
  • NPI 1134158900
  Care Compare affiliation

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1548990336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BILL BAKER WAY",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258011505",
            "telephone_number": "304-252-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013503",
            "telephone_number": "304-252-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDEN",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WV",
            "license": "ED1145A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "4280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebound Therapy and Wellness
• Shyanne Reckseen
• Brandi Redden, FNP-BC
• Carla Redden
• Felicia Redden
• Venkataprasanth Reddy, M.D.
• Redemption Services, LLC.
• Debra Kay Redman
• Jeremiah Reece
• Allie Reed, M.S.P.A.-C

• Family Medicine Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.