Individual provider Active NPI

Maria Irvin, NP

  • Pediatric Nurse Practitioner
  • Morgantown, WV
National Provider Identifier
1821765017
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
110480 Issued in WV
Practice address
9000 Coombs Farm Rd Ste 102
Morgantown, WV 26508-1150
Phone
(304) 599-8003
Fax
(304) 599-8003
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 110480 WV Primary

Addresses

Primary practice location

9000 Coombs Farm Rd Ste 102
Morgantown, WV 26508-1150

Mailing address

1247 Suncrest Town Centre Dr
Morgantown, WV 26505-1876
Phone (304) 599-8000

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
110480WVMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardinal Pediatrics PLLC PastSince Aug 29, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1821765017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 SUNCREST TOWN CENTRE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051876",
            "telephone_number": "304-599-8000",
            "fax_number": "304-599-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 COOMBS FARM RD STE 102",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081150",
            "telephone_number": "304-599-8003",
            "fax_number": "304-599-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WV",
            "license": "110480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.