Individual provider Active NPI

Jordan Shay

  • Anesthesiology Physician
  • Morgantown, WV
National Provider Identifier
1770119638
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
3965 Issued in WV
Practice address
1 Medical Center Dr # 8255
Morgantown, WV 26506-1200
Phone
(304) 598-4480
Fax
(304) 598-4930
NPI assigned
Mar 22, 2020
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 3965 WV Primary

Addresses

Primary practice location

1 Medical Center Dr # 8255
Morgantown, WV 26506-1200

Mailing address

1 Medical Center Dr # 8255
Morgantown, WV 26506-1200
Phone (304) 598-4480

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
I20240912001612 WV Practitioner - Anesthesiology 1456891860 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
West Virginia University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 293-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3965WVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince May 13, 2024 Accepting new patients
West Virginia University Medical Corporation Anesthesiology CurrentSince May 13, 2024 Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

1 Medical Center Dr
#8255
Morgantown, WV 26506
Phone (304) 598-4480

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Organizations & group practices 3

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 1

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": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1770119638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR # 8255",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061200",
            "telephone_number": "304-598-4480",
            "fax_number": "304-598-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR # 8255",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061200",
            "telephone_number": "304-598-4480",
            "fax_number": "304-598-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAY",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-22",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "3965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.