Individual provider Active NPI

Miyuki N. Ege, MA

  • Clinical Psychologist
  • Charleston, WV
National Provider Identifier
1912537424
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1228 Issued in WV
Practice address
333 Laidley St FL 4E
Charleston, WV 25301-1614
Phone
(304) 766-4560
Fax
(304) 766-4599
NPI assigned
Jan 23, 2020
Last updated
Jan 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1228 WV Primary

Addresses

Primary practice location

333 Laidley St FL 4E
Charleston, WV 25301-1614

Mailing address

4605 Maccorkle Ave SW Ofc
South Charleston, WV 25309-1311
Phone (304) 414-4800

Other practice location 1

500 Poplar St Ste 204
South Charleston, WV 25309-1472
Phone (304) 414-2895

Other practice location 2

333 Laidley St Fl 4W
Charleston, WV 25301-1614
Phone (304) 766-4560

Other names 1

  • Miyuki Nakamura Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200309001873 WV Practitioner - Psychologist Billing Independently 4789012568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
THS Physician Partners Inc CurrentSince Jan 13, 2020 Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

333 Laidley St
Fl 4E
Charleston, WV 25301
Phone (304) 766-4560

333 Laidley St
Fl 4W
Charleston, WV 25301
Phone (304) 766-4560

100 Peyton Way
Ste 200
South Charleston, WV 25309
Phone (904) 638-6147

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

4605 Maccorkle Ave SW
Ofc
South Charleston, WV 25309
Phone (304) 414-4800

500 Poplar St
Ste 204
South Charleston, WV 25309
Phone (304) 414-2895

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1912537424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW OFC",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-414-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LAIDLEY ST FL 4E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011614",
            "telephone_number": "304-766-4560",
            "fax_number": "304-766-4599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Poplar St Ste 204",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253091472",
            "country_code": "US",
            "telephone_number": "304-414-2895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Laidley St Fl 4W",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011614",
            "country_code": "US",
            "telephone_number": "304-766-4560",
            "fax_number": "304-766-4599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGE",
        "first_name": "MIYUKI",
        "middle_name": "N.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "1228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIYUKI",
            "last_name": "NAKAMURA",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.