Mia J Shilobod, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

01143 Issued in WV

Practice address

1300 Fort Pierpont Dr Ste 101
Morgantown, WV 26508

Phone

(304) 241-7150

Fax

(304) 599-8917

NPI assigned

Mar 23, 2006

Last updated

Nov 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• GR&W, Inc

  dba GR&W Harmony

  • Clinical Neuropsychologist
  • Morgantown, WV
  • NPI 1407192024
  Medicare reassignment
• Monongahela Valley Association of Health Centers, Inc

  dba MVA Fairmont Clinic

  • Federally Qualified Health Center (FQHC)
  • Fairmont, WV
  • NPI 1770697278
  NPD
• Monongahela Valley Association of Health Centers, Inc.

  dba MVA Fairmont Clinic Pharmacy

  • Clinic Pharmacy
  • Fairmont, WV
  • NPI 1609979673
  NPD
• GR&W, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morgantown, WV
  • NPI 1992665723
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1922067271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 MEMORIAL CHURCH DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26501",
            "telephone_number": "304-292-7316",
            "fax_number": "304-599-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FORT PIERPONT DR STE 101",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26508",
            "telephone_number": "304-241-7150",
            "fax_number": "304-599-8917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Fairmont Rd",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265013847",
            "country_code": "US",
            "telephone_number": "304-292-7316",
            "fax_number": "304-599-8917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Mon Health Medical Park Dr Ste 1201",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265051143",
            "country_code": "US",
            "telephone_number": "304-599-9400",
            "fax_number": "304-599-8917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6000 Memorial Church Drive",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "26501",
            "country_code": "US",
            "telephone_number": "304-292-7316",
            "fax_number": "304-599-8917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHILOBOD",
        "first_name": "MIA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "01143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Nathaniel Sherwood, M.D.
• Sameer Atul Shetty
• Michael Shi
• Ashley Marie Shiflett, APRN
• Dwayne Shillingburg, PTA
• Aishwarya Shimpi, MD
• Julie Beth Wilson Shinaberry, LMT
• Alexis Shine, PRSS
• Jennifer Shinn
• Bridget Shinnick, CRNA, DNAP

• Medical Physician Assistant in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.