Active NPI
David W. Facello, DO
- Family Medicine Physician
- Elkins, WV
National Provider Identifier
1649498080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2131
- Practice address
- 812 Gorman Ave
Elkins, WV 26241-3181 - Phone
- (304) 637-3456
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A11410 | CA | |
| Family Medicine Physician | 207Q00000X | 007768 | AZ | |
| Family Medicine Physician | 207Q00000X | DO-05251 | IA | |
| Family Medicine Physician | 207Q00000X | 036147010 | IL | |
| Family Medicine Physician | 207Q00000X | 64331 | MN | |
| Family Medicine Physician | 207Q00000X | 1868 | NE | |
| Family Medicine Physician | 207Q00000X | 19103 | NH | |
| Family Medicine Physician | 207Q00000X | 31-321 | WI | |
| Family Medicine Physician | 207Q00000X | 05-41277 | KS | |
| Family Medicine Physician | 207Q00000X | 2018-02840 | NC | |
| Family Medicine Physician | 207Q00000X | 2131 | WV | Primary |
Addresses
Primary practice location
812 Gorman Ave
Elkins, WV 26241-3181
Mailing address
812 Gorman Ave
Elkins, WV 26241-3181
Phone (304) 637-3456
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2131 | WV | MD | Counselor |
| 007768 | AZ | MD | Family Medicine Physician |
| 20A11410 | CA | MD | Family Medicine Physician |
| DO-05251 | IA | MD | Family Medicine Physician |
| 036147010 | IL | MD | Family Medicine Physician |
| 05-41277 | KS | MD | Family Medicine Physician |
| 64331 | MN | MD | Family Medicine Physician |
| 2018-02840 | NC | MD | Family Medicine Physician |
| 1868 | NE | MD | Family Medicine Physician |
| 19103 | NH | MD | Family Medicine Physician |
| 31-321 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565308800000",
"number": "1649498080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 GORMAN AVE",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413181",
"telephone_number": "304-637-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 GORMAN AVE",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413181",
"telephone_number": "304-637-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FACELLO",
"first_name": "DAVID",
"middle_name": "W.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-23",
"last_updated": "2019-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A11410",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "007768",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "DO-05251",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036147010",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "64331",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "1868",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NH",
"license": "19103",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "31-321",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "05-41277",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2018-02840",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "2131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.