Active NPI
Roy Clifford Massey IV, PRSS
- Peer Specialist
- Malden, WV
National Provider Identifier
1821700576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 4202 Malden Dr
Malden, WV 25306-6442 - Phone
- (681) 208-3750
- Fax
- (304) 926-1260
- NPI assigned
- Dec 14, 2022
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
4202 Malden Dr
Malden, WV 25306-6442
Mailing address
PO Box 8413
South Charleston, WV 25303-0413
Phone (304) 200-3472
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lotus.recovery@outlook.com | Direct |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lotus Recovery Center LLC | Current | Accepting new patients | |
| Lotus Recovery Center LLC | Current | Accepting new patients |
Locations
4202 Malden Dr
Malden, WV 25306
Phone (304) 928-5144
Interoperability endpoints
- https://api.platform.athenahealth.com/22891/brand/1/csg/1/fhir/r4
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.
-
- Multi-Specialty Clinic/Center
- Charleston, WV
- NPI 1710648431
-
- Community/Behavioral Health Agency
- Malden, WV
- NPI 1902407034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670976000000",
"number": "1821700576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8413",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253030413",
"telephone_number": "304-200-3472",
"fax_number": "304-926-1290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4202 MALDEN DR",
"city": "MALDEN",
"state": "WV",
"postal_code": "253066442",
"telephone_number": "681-208-3750",
"fax_number": "304-926-1260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSEY",
"first_name": "ROY",
"middle_name": "CLIFFORD",
"name_prefix": "Mr.",
"name_suffix": "IV",
"credential": "PRSS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-14",
"last_updated": "2022-12-14",
"certification_date": "2022-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lotus.recovery@outlook.com",
"affiliation": "N",
"endpointDescription": "Private email address that is HIPPA compliant",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4202 Malden Dr",
"city": "Malden",
"state": "WV",
"country_code": "US",
"postal_code": "253066442",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Malden, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.