William Jeffrey Earley, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

340040000 Issued in OH

Practice address

800 Grand Central Mall Ste 11
Vienna, WV 26105-4100

Phone

(304) 916-1270

Fax

(304) 916-1705

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1770595043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054100",
            "telephone_number": "304-916-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL STE 11",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054100",
            "telephone_number": "304-916-1270",
            "fax_number": "304-916-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLEY",
        "first_name": "WILLIAM",
        "middle_name": "JEFFREY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "340040000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0620331",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00314908",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Vienna, WV
• Providers in Vienna, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.