Active NPI
Wilma A. Mansfield, M.D.
- Family Medicine Physician
- Pomeroy, OH
National Provider Identifier
1962440198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35-039790
- Practice address
- 88 E Memorial Dr
Pomeroy, OH 45769-9569 - Phone
- (740) 992-0060
- Fax
- (740) 446-5154
- NPI assigned
- Jun 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35-039790 | OH | Primary |
| Family Medicine Physician | 207Q00000X | 21086 | WV |
Addresses
Primary practice location
88 E Memorial Dr
Pomeroy, OH 45769-9569
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 992-0060
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 310917085062 | Other | OH | CARESOURCE MEDICAID |
| 0056270000 | Medicaid | WV | |
| 0391759 | Other | OH | MOLINA MEDICAID |
| 001714086 | Other | MOUNTAIN STATE BCBS | |
| 080076943 | Other | RR MEDICARE | |
| 000000007616 | Other | ANTHEM BCBS | |
| 000000181523 | Other | OH | UNISON MEDICAID |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-039790 | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423180800000",
"number": "1962440198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-992-0060",
"fax_number": "740-446-5154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 E MEMORIAL DR",
"city": "POMEROY",
"state": "OH",
"postal_code": "457699569",
"telephone_number": "740-992-0060",
"fax_number": "740-446-5154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSFIELD",
"first_name": "WILMA",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-02",
"last_updated": "2015-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35-039790",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "21086",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE MEDICAID",
"identifier": "310917085062",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0056270000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA MEDICAID",
"identifier": "0391759",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOUNTAIN STATE BCBS",
"identifier": "001714086",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "080076943",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000007616",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON MEDICAID",
"identifier": "000000181523",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pomeroy, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.