Individual provider Active NPI

Jayne Ladier Canterbury, D.O.

  • Family Medicine Physician
  • Peterstown, WV
National Provider Identifier
1760433254
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1562 Issued in WV
Practice address
2869 Seneca TRL S
Peterstown, WV 24963-5037
Phone
(304) 753-4336
Fax
(304) 772-5553
NPI assigned
May 12, 2006
Last updated
Jan 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1562 WV Primary

Addresses

Primary practice location

2869 Seneca TRL S
Peterstown, WV 24963-5037

Mailing address

PO Box 590
Union, WV 24983-0590
Phone (304) 772-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040407000228 WV Practitioner - Family Practice 7012900806 Reassigns benefits to 1 organization
Practice locations: Union, WV

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

PO Box
Suite 590
Union, WV 24983

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1562WVMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe County Health Center Board of Trustees CurrentSince Jul 28, 2018 Accepting new patients
Monroe County Health Center, Board of Trustees CurrentSince Jul 28, 2018 Accepting new patients
Monroe County Health Center Board of Trustees Current Accepting new patients
Monroe County Health Center Board of Trustees Past Accepting new patients

Locations

142 James Monroe Dr
Lindside, WV 24951
Phone (304) 753-5940

200 Health Center Dr
Union, WV 24983
Phone (304) 772-3064

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71937

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1760433254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 590",
            "city": "UNION",
            "state": "WV",
            "postal_code": "249830590",
            "telephone_number": "304-772-5555",
            "fax_number": "304-772-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2869 SENECA TRL S",
            "city": "PETERSTOWN",
            "state": "WV",
            "postal_code": "249635037",
            "telephone_number": "304-753-4336",
            "fax_number": "304-772-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTERBURY",
        "first_name": "JAYNE",
        "middle_name": "LADIER",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peterstown, WV

Sources for this page

Verify at the official NPI Registry.