Individual provider Active NPI

David W. Facello, DO

  • Family Medicine Physician
  • Elkins, WV
National Provider Identifier
1649498080
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2131 Issued in WV
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

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071004000705 WV Practitioner - Family Practice 0749375764 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2131WVMDCounselor
007768AZMDFamily Medicine Physician
20A11410CAMDFamily Medicine Physician
DO-05251IAMDFamily Medicine Physician
036147010ILMDFamily Medicine Physician
05-41277KSMDFamily Medicine Physician
64331MNMDFamily Medicine Physician
2018-02840NCMDFamily Medicine Physician
1868NEMDFamily Medicine Physician
19103NHMDFamily Medicine Physician
31-321WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Mar 4, 2026 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

Verify at the official NPI Registry.