NPIMap

Individual provider Active NPI

Lora B. Fetty, MD

  • Internal Medicine Physician
  • Huntington, WV
National Provider Identifier
1871913368
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28068 Issued in WV
Practice address
1249 15TH St
Suite 2000
Huntington, WV 25701
Phone
(304) 691-1000
Fax
(304) 691-1693
NPI assigned
Apr 23, 2014
Last updated
Dec 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28068 WV Primary

Addresses

Primary practice location

1249 15TH St
Suite 2000
Huntington, WV 25701

Mailing address

1249 15TH St
Suite 2000
Huntington, WV 25701-3662
Phone (304) 691-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lora.fetty@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181031002790 WV Practitioner - Internal Medicine 6002033990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
JC Edwards School of Medicine, Marshall University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1249 15TH St
Suite 2000
Huntington, WV 25701-3662
Phone (304) 691-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28068WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince Jul 9, 2018 Accepting new patients
University Physicians & Surgeons, Inc Internal Medicine CurrentSince Jul 9, 2018 Accepting new patients

Locations

1249 15th St
Ste 2000
Huntington, WV 25701
Phone (304) 691-1086

1249 15th St
Ste 4093
Huntington, WV 25701
Phone (304) 691-8714

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

1600 Medical Center Dr
Ste G500
Huntington, WV 25701
Phone (304) 691-1262

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1871913368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 15TH ST",
            "address_2": "SUITE 2000",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013662",
            "telephone_number": "304-691-1000",
            "fax_number": "304-691-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 15TH ST",
            "address_2": "SUITE 2000",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25701",
            "telephone_number": "304-691-1000",
            "fax_number": "304-691-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTY",
        "first_name": "LORA",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "28068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lora.fetty@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1249 15th St",
            "address_2": "Suite 2000",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "25701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.