Active NPI
Jennifer L. Midkiff, PT
- Physical Therapist
- Charleston, WV
National Provider Identifier
1902822984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 001163
- Practice address
- 313 Maccorkle Ave SW
Charleston, WV 25303-1263 - Phone
- (304) 744-2300
- Fax
- (304) 744-8195
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 001163 | WV | Primary |
Addresses
Primary practice location
313 Maccorkle Ave SW
Charleston, WV 25303-1263
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (304) 744-2300
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000217253 | Other | ANTHEM BCBS | |
| 2229010 | Medicaid | OH | |
| 0157388000 | Medicaid | WV | |
| 000000216606 | Other | OH | OH MEDICAID UNISON |
| 000646536 | Other | MOUNTAIN STATE BCBS | |
| 650019721 | Other | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001163 | WV | MD | Physical Therapy Assistant |
| 1163 | WV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1902822984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "304-744-2300",
"fax_number": "304-744-8195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 MACCORKLE AVE SW",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253031263",
"telephone_number": "304-744-2300",
"fax_number": "304-744-8195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDKIFF",
"first_name": "JENNIFER",
"middle_name": "L.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "001163",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000217253",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2229010",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0157388000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH MEDICAID UNISON",
"identifier": "000000216606",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOUNTAIN STATE BCBS",
"identifier": "000646536",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "650019721",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.