NPIMap

Individual provider Active NPI

Jason M Bird

  • Family Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1962065243
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
102771 Issued in WV
Practice address
2828 1St Ave Ste 200
Huntington, WV 25702-1236
Phone
(304) 399-7530
Fax
(304) 399-7532
NPI assigned
Apr 22, 2019
Last updated
Apr 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 102771 WV Primary

Addresses

Primary practice location

2828 1St Ave Ste 200
Huntington, WV 25702-1236

Mailing address

PO Box 4190
Barboursville, WV 25504-4190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190522002775 WV Practitioner - Nurse Practitioner 3870836455 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh General Hospital LLCGroup PAC ID 6103735154, 27 clinicians

Practice addresses (Care Compare)

1710 Harper Rd
Beckley, WV 25801-3357
Phone (304) 252-0641

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh General Hospital LLC CurrentSince Sep 1, 2021 Accepting new patients
St. Mary's Medical Management, LLC Family CurrentSince May 6, 2019 Accepting new patients
Raleigh General Hospital LLC CurrentSince Sep 1, 2021 Accepting new patients
St. Mary's Medical Management, LLC CurrentSince May 6, 2019 Accepting new patients
St Mary's Hospitalist Services, LLC Family CurrentSince Aug 1, 2021 Accepting new patients
Raleigh General Hospital Past Accepting new patients

Locations

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

1717 Harper Rd
Ste A
Beckley, WV 25801
Phone (304) 461-3879

1717 Harper Rd
Ste G
Beckley, WV 25801
Phone (304) 461-3700

2828 1st Ave
Ste 200
Huntington, WV 25702
Phone (304) 399-7530

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

2900 1st Ave
Rm 1025
Huntington, WV 25702
Phone (304) 399-7484

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

Interoperability endpoints

  • Direct secure messaging: jason.bird.1@20211.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1962065243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4190",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255044190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 1ST AVE STE 200",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021236",
            "telephone_number": "304-399-7530",
            "fax_number": "304-399-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "JASON",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "102771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.