Active NPI
Anthony Wayne Stevenson, PRSS
- Peer Specialist
- Charleston, WV
National Provider Identifier
1699663013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 25-979SUD
- Practice address
- 9103 California Ave Apt 17
Charleston, WV 25315-2045 - Phone
- (513) 295-0735
- NPI assigned
- Jun 25, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 25-979SUD | WV | Primary |
Addresses
Primary practice location
9103 California Ave Apt 17
Charleston, WV 25315-2045
Mailing address
9103 California Ave Apt 17
Charleston, WV 25315-2045
Phone (513) 295-0735
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25-979SUD | WV | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753920000000",
"number": "1699663013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9103 CALIFORNIA AVE APT 17",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253152045",
"telephone_number": "513-295-0735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9103 CALIFORNIA AVE APT 17",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253152045",
"telephone_number": "513-295-0735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "ANTHONY",
"middle_name": "WAYNE",
"credential": "PRSS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-06-25",
"last_updated": "2025-07-31",
"certification_date": "2025-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Peer Specialist",
"state": "WV",
"license": "25-979SUD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.