Individual provider Active NPI

Sarah Doutt

  • Licensed Practical Nurse
  • Charleston, WV
National Provider Identifier
1649996042
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
38500 Issued in WV
Practice address
900 Virginia St E Ste 500
Charleston, WV 25301-2805
Phone
(681) 313-4759
NPI assigned
Oct 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 38500 WV Primary

Addresses

Primary practice location

900 Virginia St E Ste 500
Charleston, WV 25301-2805

Mailing address

900 Virginia St E Ste East500
Charleston, WV 25301-2835
Phone (681) 313-4759

Other identifiers 1

IdentifierTypeStateIssuer
3810003343MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL maximcaremobile

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38500WVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1649996042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VIRGINIA ST E STE EAST500",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012835",
            "telephone_number": "681-313-4759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 VIRGINIA ST E STE 500",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012805",
            "telephone_number": "681-313-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUTT",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "38500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003343",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "maximcaremobile",
            "affiliation": "N",
            "address_1": "900 Virginia St E Ste East500",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253012835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.