Individual provider Active NPI

Maranda Gilkerson

  • Home Health Aide
  • Logan, WV
National Provider Identifier
1962208090
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
590 Lower Dempsey Branch Rd
Logan, WV 25601-9665
Phone
(304) 688-8574
NPI assigned
Feb 20, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

590 Lower Dempsey Branch Rd
Logan, WV 25601-9665

Mailing address

590 Lower Dempsey Branch Rd
Logan, WV 25601-9665

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": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1962208090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 LOWER DEMPSEY BRANCH RD",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256019665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 LOWER DEMPSEY BRANCH RD",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256019665",
            "telephone_number": "304-688-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILKERSON",
        "first_name": "MARANDA",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.