Active NPI
Kelia Lodge
- Peer Specialist
- Bridgeport, WV
National Provider Identifier
1871497651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 100 Market PL
Bridgeport, WV 26330-9168 - Phone
- (304) 848-5770
- NPI assigned
- Oct 6, 2026
- Last updated
- Oct 6, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
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 | NU | Primary |
Addresses
Primary practice location
100 Market PL
Bridgeport, WV 26330-9168
Mailing address
100 Market PL
Bridgeport, WV 26330-9168
Phone (304) 848-5770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791244800000",
"number": "1871497651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MARKET PL",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263309168",
"telephone_number": "304-848-5770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MARKET PL",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263309168",
"telephone_number": "304-848-5770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LODGE",
"first_name": "KELIA",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2026-10-06",
"last_updated": "2026-10-06",
"certification_date": "2026-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.