Individual provider Active NPI

James Scott Mizes, PH.D.

  • Clinical Psychologist
  • Morgantown, WV
National Provider Identifier
1720051386
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
763 Issued in WV
Practice address
235 High St
Suite 608
Morgantown, WV 26505-5429
Phone
(304) 413-4728
Fax
(304) 581-3201
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 763 WV Primary

Addresses

Primary practice location

235 High St
Suite 608
Morgantown, WV 26505-5429

Mailing address

44 McKinley St
Morgantown, WV 26501-4265
Phone (304) 685-6062

Other identifiers 1

IdentifierTypeStateIssuer
9202017000MedicaidWV

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 Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1720051386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MCKINLEY ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265014265",
            "telephone_number": "304-685-6062",
            "fax_number": "304-581-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 HIGH ST",
            "address_2": "SUITE 608",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055429",
            "telephone_number": "304-413-4728",
            "fax_number": "304-581-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZES",
        "first_name": "JAMES",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9202017000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.