Active NPI
Mary S Boyd, MD
- Pediatrics Physician
- Elkins, WV
National Provider Identifier
1770539447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 12283
- Practice address
- 911 Gorman Ave
Ste 302
Elkins, WV 26241 - Phone
- (304) 636-2920
- Fax
- (304) 636-2921
- NPI assigned
- May 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 12283 | WV | Primary |
Addresses
Primary practice location
911 Gorman Ave
Ste 302
Elkins, WV 26241
Mailing address
PO Drawer 2418
911 Gorman Ave Ste 302
Elkins, WV 26241
Phone (304) 636-2920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0112404000 | Medicaid | WV |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220527001727 | WV | Order and Referring Only - Pediatric Medicine | 3870971120 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Health Care, Inc | Past | Accepting new patients | |
| Randolph Elkins Health Department | Past | Accepting new patients |
Interoperability endpoints
- mary.boyd.1@7274.direct.athenahealth.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Public Health or Welfare Agency
- Elkins, WV
- NPI 1316067143
-
- Federally Qualified Health Center (FQHC)
- Mill Creek, WV
- NPI 1801861083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1770539447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO DRAWER 2418",
"address_2": "911 GORMAN AVE STE 302",
"city": "ELKINS",
"state": "WV",
"postal_code": "26241",
"telephone_number": "304-636-2920",
"fax_number": "304-636-2921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 GORMAN AVE",
"address_2": "STE 302",
"city": "ELKINS",
"state": "WV",
"postal_code": "26241",
"telephone_number": "304-636-2920",
"fax_number": "304-636-2921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "MARY",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WV",
"license": "12283",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0112404000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.