Anthony J Derby
Individual provider Active NPI Personal Care Attendant · Burton, WV
NPI 1942014204 · NPPES record last updated Feb 5, 2025
Key facts
- NPI
- 1942014204
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 937 Morgan Run Rd
Burton, WV 26562-6293 - Phone
- (304) 360-7151
- NPI assigned
- Feb 5, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
937 Morgan Run Rd
Burton, WV 26562-6293
Mailing address
937 Morgan Run Rd
Burton, WV 26562-6293
Phone (304) 360-7151
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125553494 | Medicaid | WV | |
| 1356607394 | Medicaid | WV | |
| 1821206228 | Medicaid | WV |
Other providers in Burton, WV
- Barbe Physical Therapy LLC
- Barbe Rehabilitation & Sports Medicine
- Steven P Barbe
- Clay-Battelle Health Services Association
- Clay-Battelle Health Services Association
- Mickayla Derby
- Angel Forren
- Angel M Hixenbaugh
- Shannon Michael
- Judy Kaye Moore
All providers in Burton, WV · Personal Care Attendant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.