Jeffery Dwayne Wright
Individual provider Active NPI Personal Care Attendant · Matoka, WV
NPI 1871196352 · NPPES record last updated Nov 18, 2020
Key facts
- NPI
- 1871196352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 146 Valley Street
Matoka, WV 24736 - Phone
- (304) 910-1219
- NPI assigned
- Nov 18, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
146 Valley Street
Matoka, WV 24736
Mailing address
PO Box 3
Matoaka, WV 24736-0003
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.