Individual provider Active NPI

Mark A Myers, M.D.

  • Family Medicine Physician
  • Ridgeley, WV
National Provider Identifier
1710986658
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13567 Issued in WV
Practice address
RR 3 Box 142
Hunt Club Plaza
Ridgeley, WV 26753-9500
Phone
(304) 726-4501
Fax
(304) 726-4051
NPI assigned
Jul 20, 2005
Last updated
Apr 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13567 WV Primary
Family Medicine Physician 207Q00000X D32235 MD

Addresses

Primary practice location

RR 3 Box 142
Hunt Club Plaza
Ridgeley, WV 26753-9500

Mailing address

RR 3 Box 142
Hunt Club Plaza
Ridgeley, WV 26753-9500
Phone (304) 726-4501

Other identifiers 5

IdentifierTypeStateIssuer
E458 0007OtherDCBLUE CHOICE BC BS
0056925000MedicaidWV
41843503OtherMDCAREFIRST BC BS
000513375OtherWVMT. STATE BC BS
080188048OtherTRAVELERS MEDICARE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D32235MDMDFamily Medicine Physician
13567WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Western Maryland Health Services, LLC Past Accepting new patients
Cumberland Emergency Medical Group PA Past Accepting new patients
Upmc Western Maryland Corporation Past Accepting new patients
Cumberland Emergency Medical Group, PA Family Medicine Past Accepting new patients
Memorial Hospital and Medical Center of Cumberland, Inc. Past Accepting new patients

Organizations & group practices 5

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1710986658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 142",
            "address_2": "HUNT CLUB PLAZA",
            "city": "RIDGELEY",
            "state": "WV",
            "postal_code": "267539500",
            "telephone_number": "304-726-4501",
            "fax_number": "304-726-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 142",
            "address_2": "HUNT CLUB PLAZA",
            "city": "RIDGELEY",
            "state": "WV",
            "postal_code": "267539500",
            "telephone_number": "304-726-4501",
            "fax_number": "304-726-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "13567",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D32235",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE BC BS",
            "identifier": "E458  0007",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056925000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC BS",
            "identifier": "41843503",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT. STATE BC BS",
            "identifier": "000513375",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "080188048",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.