Individual provider Active NPI

Yohalmo Esau Escobar Leiva, RN

  • Registered Nurse
  • Martinsburg, WV
National Provider Identifier
1821605692
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
104822 Issued in WV
Practice address
2500 Hospital Dr
Martinsburg, WV 25401-3402
Phone
(304) 264-1000
NPI assigned
Sep 25, 2020
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 104822 WV Primary

Addresses

Primary practice location

2500 Hospital Dr
Martinsburg, WV 25401-3402

Mailing address

167 Spyglass Dr
Martinsburg, WV 25403-1397
Phone (703) 365-5811

Other identifiers 1

IdentifierTypeStateIssuer
F964955OtherWVAPPLYING FOR FEDERAL JOB RN AT THE VA

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
104822WVMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1821605692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 SPYGLASS DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254031397",
            "telephone_number": "703-365-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254013402",
            "telephone_number": "304-264-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBAR LEIVA",
        "first_name": "YOHALMO",
        "middle_name": "ESAU",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "104822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APPLYING FOR FEDERAL JOB RN AT THE VA",
            "identifier": "F964955",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.