Active NPI
Jadan Jennings
- Community Health Worker
- Wyco, WV
National Provider Identifier
1962097345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 1259 Wyco Hollow Road
Wyco, WV 25943 - Phone
- (304) 294-6851
- NPI assigned
- Mar 8, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
1259 Wyco Hollow Road
Wyco, WV 25943
Mailing address
PO Box 2
Wyco, WV 25943-0002
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1962097345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2",
"city": "WYCO",
"state": "WV",
"postal_code": "259430002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1259 WYCO HOLLOW ROAD",
"city": "WYCO",
"state": "WV",
"postal_code": "25943",
"telephone_number": "304-294-6851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "JADAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-08",
"last_updated": "2021-03-08",
"certification_date": "2021-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyco, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.