Active NPI
Beverly Jovon Sadler, ICPR
- Peer Specialist
- Charleston, WV
National Provider Identifier
1982330973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 21-936
- Practice address
- 408 Tennessee Ave
Charleston, WV 25302-2338 - Phone
- (304) 541-7243
- NPI assigned
- Aug 1, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 21-936 | WV | Primary |
Addresses
Primary practice location
408 Tennessee Ave
Charleston, WV 25302-2338
Mailing address
1622 Virginia St E Apt a
Charleston, WV 25311-2143
Phone (304) 541-7243
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21-936 | WV | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MSRC, LLC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1982330973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1622 VIRGINIA ST E APT A",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253112143",
"telephone_number": "304-541-7243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 TENNESSEE AVE",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253022338",
"telephone_number": "304-541-7243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SADLER",
"first_name": "BEVERLY",
"middle_name": "JOVON",
"credential": "ICPR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-01",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Peer Specialist",
"state": "WV",
"license": "21-936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.