JACK SHOMO - NPI 1063212835 - Peer Specialist in Elkins, WV

Q: What is Jack Shomo's NPI number?

The NPI number for Jack Shomo is 1063212835. It was assigned to this individual provider in the NPPES registry on March 19, 2025.

Q: What is Jack Shomo's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Shomo was last updated on March 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Jack Shomo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK SHOMO (NPI 1063212835) is an individual peer specialist in Elkins, West Virginia and active in the NPI registry since March 2025.

NPPES Registry Identity

NPI1063212835

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameJACK SHOMO

Location Address1123 S DAVIS AVEElkins, WV 26241-3529

Mailing Address1008 S Davis AveElkins, WV 26241-3528 · (304) 621-5223 · Fax (304) 621-5223

Phone(681) 378-3908

Sole ProprietorNo

Enumeration DateMarch 19, 2025

NPPES CertifiedMarch 19, 2025

✔ NPI 1063212835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

1123 S DAVIS AVE, Elkins, WV 26241

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Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMANTHA DANIELLE RYAN

Peer Specialist