Active NPI
Shea Thomas
- Dental Hygienist
- Glenville, WV
National Provider Identifier
1558146944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2830
- Practice address
- 201 Fci LN
Glenville, WV 26351-9500 - Phone
- (304) 626-2500
- NPI assigned
- Aug 25, 2023
- Last updated
- Aug 25, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2830 | WV | Primary |
Addresses
Primary practice location
201 Fci LN
Glenville, WV 26351-9500
Mailing address
2563 Maple Ave
Fayetteville, WV 25840-6825
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2830 | WV | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1558146944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2563 MAPLE AVE",
"city": "FAYETTEVILLE",
"state": "WV",
"postal_code": "258406825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 FCI LN",
"city": "GLENVILLE",
"state": "WV",
"postal_code": "263519500",
"telephone_number": "304-626-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "SHEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-25",
"last_updated": "2023-08-25",
"certification_date": "2023-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WV",
"license": "2830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.