Organization Active NPI

Zachary Schott LLC

  • Clinic/Center
  • Bridgeport, WV
National Provider Identifier
1619791563
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ZACHARY SCHOTT LLC
Practice address
120 Professional PL # 103
Bridgeport, WV 26330-4599
Phone
(304) 969-4885
Fax
(304) 853-5859
NPI assigned
Nov 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Authorized official

Name
Zachary Schott, FNP-CNPI 1861073025
Title
Owner/Provider
Phone
(304) 518-1861

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

120 Professional PL # 103
Bridgeport, WV 26330-4599

Mailing address

207 Gandalf Rd
Masontown, WV 26542-9023

Other names 1

  • Bridgeport Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250216000031 WV Part B Supplier - Clinic/Group Practice 2062942303 Receives reassigned benefits from 2 practitioners
Practice locations: Bridgeport, WV

National Provider Directory

National Provider Directory

Locations

8000 Jerry Dove Dr
Ste 110
Bridgeport, WV 26330

120 Professional Pl
#103
Bridgeport, WV 26330
Phone (304) 969-4885

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756339200000",
    "number": "1619791563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 GANDALF RD",
            "city": "MASONTOWN",
            "state": "WV",
            "postal_code": "265429023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROFESSIONAL PL # 103",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263304599",
            "telephone_number": "304-969-4885",
            "fax_number": "304-853-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZACHARY SCHOTT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A",
        "authorized_official_last_name": "SCHOTT",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "304-518-1861",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeport Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bridgeport Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.