Individual provider Active NPI

Jarrel Kenyatta, M.D.

  • Emergency Medicine Physician
  • Webster Springs, WV
National Provider Identifier
1881647691
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
23910 Issued in WV
Practice address
125 Diana Dr
Webster Springs, WV 26288-9078
Phone
(304) 847-5682
Fax
(301) 874-5401
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23910 WV Primary
Personal Emergency Response Attendant 146D00000X MD419350 PA

Addresses

Primary practice location

125 Diana Dr
Webster Springs, WV 26288-9078

Mailing address

125 Diana Dr
Webster Springs, WV 26288-9078
Phone (304) 847-5682

Other practice location 1

147 Gettys St
Gettysburg, PA 17325-2534
Phone (717) 337-4168

Other practice location 2

6900 Georgia Ave NW
Washington, DC 20307-0003
Phone (202) 782-1947

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150526000377 PA Practitioner - Emergency Medicine 8325174501 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD419350PAMDPersonal Emergency Response Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Dec 1, 2018 Accepting new patients
Emergency Physician Associates of Pennsylvania, PC Emergency Medicine CurrentSince May 1, 2015 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Dec 1, 2018 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
Geisinger Clinic CurrentSince Jun 1, 2015 Accepting new patients
Geisinger Clinic CurrentSince Jun 1, 2015 Accepting new patients
Geisinger Clinic Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

100 N Academy Ave
Danville, PA 17822

300 Highland Ave
Hanover, PA 17331
Phone (717) 316-3711

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

Organizations & group practices 8

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1881647691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 DIANA DR",
            "city": "WEBSTER SPRINGS",
            "state": "WV",
            "postal_code": "262889078",
            "telephone_number": "304-847-5682",
            "fax_number": "301-874-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DIANA DR",
            "city": "WEBSTER SPRINGS",
            "state": "WV",
            "postal_code": "262889078",
            "telephone_number": "304-847-5682",
            "fax_number": "301-874-5401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Gettys St",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252534",
            "country_code": "US",
            "telephone_number": "717-337-4168",
            "fax_number": "717-337-4249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6900 Georgia Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "203070003",
            "country_code": "US",
            "telephone_number": "202-782-1947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENYATTA",
        "first_name": "JARREL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "23910",
            "primary": true
        },
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "PA",
            "license": "MD419350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster Springs, WV

Sources for this page

Verify at the official NPI Registry.