Active NPI
Kenneth Dean Wright, PA-C
- Physician Assistant
- Huntington, WV
National Provider Identifier
1790745818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 157
- Practice address
- 2828 1St Ave
Suite 200
Huntington, WV 25702-1236 - Phone
- (304) 399-7530
- Fax
- (304) 399-7532
- NPI assigned
- Mar 24, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 157 | WV | Primary |
Addresses
Primary practice location
2828 1St Ave
Suite 200
Huntington, WV 25702-1236
Mailing address
PO Box 88
5 E Alvon Road Suite 7
White Sulphur Springs, WV 24986-2373
Phone (304) 536-5030
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030028200 | Other | WV | BLACK LUNG |
| 95690020 | Medicaid | KY | |
| 550357050 | Other | WV | UNITED MINE WORKERS |
| 001721578 | Other | WV | BCBS MOUNTAIN STATE |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 157 | WV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Mary'S Medical Management Highlawn Lab | 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.
-
- Clinical Medical Laboratory
- Huntington, WV
- NPI 1831378504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1790745818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 88",
"address_2": "5 E ALVON ROAD SUITE 7",
"city": "WHITE SULPHUR SPRINGS",
"state": "WV",
"postal_code": "249862373",
"telephone_number": "304-536-5030",
"fax_number": "304-536-5051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2828 1ST AVE",
"address_2": "SUITE 200",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257021236",
"telephone_number": "304-399-7530",
"fax_number": "304-399-7532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "KENNETH",
"middle_name": "DEAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "157",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLACK LUNG",
"identifier": "030028200",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95690020",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED MINE WORKERS",
"identifier": "550357050",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MOUNTAIN STATE",
"identifier": "001721578",
"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 17, 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.