Individual provider Active NPI

Ezabella Lynae Preston

  • Personal Care Attendant
  • Alum Creek, WV
National Provider Identifier
1992552574
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
256 Kanawha LN
Alum Creek, WV 25003-5607
Phone
(304) 982-4502
NPI assigned
May 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Primary

Addresses

Primary practice location

256 Kanawha LN
Alum Creek, WV 25003-5607

Mailing address

256 Kanawha LN
Alum Creek, WV 25003-5607
Phone (304) 982-4502

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": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1992552574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 KANAWHA LN",
            "city": "ALUM CREEK",
            "state": "WV",
            "postal_code": "250035607",
            "telephone_number": "304-982-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 KANAWHA LN",
            "city": "ALUM CREEK",
            "state": "WV",
            "postal_code": "250035607",
            "telephone_number": "304-982-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "EZABELLA",
        "middle_name": "LYNAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alum Creek, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.