Active NPI
Jeffrey T Boggess, PH.D.
- Psychologist
- Huntington, WV
National Provider Identifier
1790717940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 544
- Practice address
- 1115 20TH Street
Suite 205
Huntington, WV 25703 - Phone
- (304) 691-1500
- Fax
- (304) 691-1510
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 544 | WV | Primary |
Addresses
Primary practice location
1115 20TH Street
Suite 205
Huntington, WV 25703
Mailing address
1115 20TH Street
Suite 205
Huntington, WV 25703
Phone (304) 691-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0163845000 | Medicaid | WV | |
| 544 | Other | WV | LICENSE OF PSYCHOLOGY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 544 | WV | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psimed, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Morgantown, WV
- NPI 1932444221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374105600000",
"number": "1790717940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 20TH STREET",
"address_2": "SUITE 205",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "25703",
"telephone_number": "304-691-1500",
"fax_number": "304-691-1510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 20TH STREET",
"address_2": "SUITE 205",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "25703",
"telephone_number": "304-691-1500",
"fax_number": "304-691-1510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGGESS",
"first_name": "JEFFREY",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2013-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WV",
"license": "544",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0163845000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE OF PSYCHOLOGY",
"identifier": "544",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.