Individual provider Active NPI

Elaine Jerry Javins, RN

  • Diabetes Educator Registered Nurse
  • Charleston, WV
National Provider Identifier
1699965210
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
40454 Issued in WV
Practice address
300 Association Dr
Suite 320
Charleston, WV 25311-1269
Phone
(304) 344-3171
NPI assigned
Jul 30, 2007
Last updated
Jul 30, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 40454 WV Primary

Addresses

Primary practice location

300 Association Dr
Suite 320
Charleston, WV 25311-1269

Mailing address

300 Association Dr
Suite 320
Charleston, WV 25311-1269
Phone (304) 344-3171

Other identifiers 1

IdentifierTypeStateIssuer
3810004840MedicaidWV

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
40454WVMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes Concepts by Javins, Inc Diabetes Educator Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1699965210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ASSOCIATION DR",
            "address_2": "SUITE 320",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111269",
            "telephone_number": "304-344-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ASSOCIATION DR",
            "address_2": "SUITE 320",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111269",
            "telephone_number": "304-344-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVINS",
        "first_name": "ELAINE",
        "middle_name": "JERRY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "WV",
            "license": "40454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004840",
            "state": "WV"
        }
    ],
    "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 30, 2007; 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.