Individual provider Active NPI

Jeri Sue Thomas, CNP

  • Nurse Practitioner
  • Green Bank, WV
National Provider Identifier
1881920387
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
43108 Issued in WV
Practice address
4914 Potomac Highlands TRL
Green Bank, WV 24944-8507
Phone
(681) 206-0668
Fax
(740) 619-7029
NPI assigned
Oct 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 43108 WV Primary
Family Nurse Practitioner 363LF0000X 11090 OH

Addresses

Primary practice location

4914 Potomac Highlands TRL
Green Bank, WV 24944-8507

Mailing address

PO Box 134
Green Bank, WV 24944-0134
Phone (681) 206-0668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100505000826 WV Practitioner - Nurse Practitioner 8224166632 Reassigns benefits to 2 organizations
I20100920000092 OH Practitioner - Nurse Practitioner 8224166632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
43108WVMDNurse Practitioner
11090OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mustard Seed Counseling and Behavioral Health Services LLC CurrentSince Nov 1, 2025 Accepting new patients
Valeo Medical, PLLC CurrentSince Feb 6, 2019 Accepting new patients
Cornerstone Medical Group of West Virginia LLC CurrentSince Nov 1, 2025 Accepting new patients
Valley Health Care, Inc Past Accepting new patients

Locations

428 Leon Sullivan Way
Charleston, WV 25301
Phone (304) 409-8128

4914 Potomac Highlands Trl
Green Bank, WV 24944
Phone (681) 206-7107

747 N Main St
Ste C
Moorefield, WV 26836
Phone (304) 530-8500

260 Russell Ave
North Martinsvlle, WV 26155
Phone (304) 398-4949

1100 9th St
Ste E
Vienna, WV 26105

Organizations & group practices 4

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": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1881920387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 134",
            "city": "GREEN BANK",
            "state": "WV",
            "postal_code": "249440134",
            "telephone_number": "681-206-0668",
            "fax_number": "740-619-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 POTOMAC HIGHLANDS TRL",
            "city": "GREEN BANK",
            "state": "WV",
            "postal_code": "249448507",
            "telephone_number": "681-206-0668",
            "fax_number": "740-619-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JERI",
        "middle_name": "SUE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "43108",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "11090",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bank, WV

Sources for this page

Verify at the official NPI Registry.