NPIMap

Individual provider Active NPI

Javier M Vallejos, MD

  • Obstetrics & Gynecology Physician
  • Harts, WV
National Provider Identifier
1598754285
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
11634 Issued in WV
Practice address
22 Fleming Drive
Harts, WV 25524
Phone
(304) 855-4595
Fax
(304) 529-0780
NPI assigned
Oct 17, 2005
Last updated
Sep 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 11634 WV Primary

Addresses

Primary practice location

22 Fleming Drive
Harts, WV 25524

Mailing address

P.O. Box 1680
Huntington, WV 25717-1680
Phone (304) 697-1396

Other identifiers 3

IdentifierTypeStateIssuer
001721259OtherWVBC
64694268MedicaidKY
0094185000MedicaidWV

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Area Health Systems Past Accepting new patients
Area Health Systems Incorporated Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1598754285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 FLEMING DRIVE",
            "city": "HARTS",
            "state": "WV",
            "postal_code": "25524",
            "telephone_number": "304-855-4595",
            "fax_number": "304-529-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJOS",
        "first_name": "JAVIER",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WV",
            "license": "11634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "001721259",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64694268",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094185000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harts, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.