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NPI 1104500636, an individual provider in CHARLESTON, WV 25387.

NPI
1104500636
Entity type
Individual (type 1)
Status
Active
Practice location
CHARLESTON, WV 25387
Enumerated
2023-06-14
Last updated
2023-06-14
Request
curl https://api.healthcare.dev/v1/providers/1104500636 \
  -H "Authorization: Bearer $HDEV_API_KEY"

NPPES

Taxonomy codes

  • 3747P1801X Primary

Codes from the Health Care Provider Taxonomy code set; their names belong to the NUCC and aren't shown here.

Official record

The CMS NPI Registry is the official source for this NPI: NPI 1104500636 in the NPI Registry.

Use it

Look up 1104500636 from code or an agent

curl
curl https://api.healthcare.dev/v1/providers/1104500636 \
  -H "Authorization: Bearer $HDEV_API_KEY"
MCP prompt
Using the healthcare.dev MCP server, look up NPI 1104500636. Tell me the provider's name, whether it is an individual or an organization, whether the NPI is active, its taxonomy codes and its practice city and state.

Source: CMS NPPES file, release 2026-11. Public (FOIA-disclosable). Registry data as CMS publishes it, not a verification of credentials, licensure or enrollment.