Active NPI
Joni M Struckman, PA C
- Physician Assistant
- Coal City, WV
National Provider Identifier
1619059177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 454
- Practice address
- 850 Independence Road
Coal City, WV 25823-1595 - Phone
- (304) 469-2905
- Fax
- (304) 683-6906
- NPI assigned
- Oct 20, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 01260 | WV | |
| Physician Assistant | 363A00000X | 454 | WV | Primary |
Addresses
Primary practice location
850 Independence Road
Coal City, WV 25823-1595
Mailing address
PO Box 337
Scarbro, WV 25917
Phone (304) 465-1378
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810007575 | Medicaid | WV |
Other names 1
- Joni M. Walker
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 454 | WV | MD | Professional Counselor |
| 01260 | WV | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589760000000",
"number": "1619059177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 337",
"city": "SCARBRO",
"state": "WV",
"postal_code": "25917",
"telephone_number": "304-465-1378",
"fax_number": "304-469-2981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 INDEPENDENCE ROAD",
"city": "COAL CITY",
"state": "WV",
"postal_code": "258231595",
"telephone_number": "304-469-2905",
"fax_number": "304-683-6906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRUCKMAN",
"first_name": "JONI",
"middle_name": "M",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-20",
"last_updated": "2020-05-18",
"certification_date": "2020-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "01260",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "454",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810007575",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JONI",
"last_name": "WALKER",
"middle_name": "M.",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Coal City, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.