SHANIAH SHONTAE HOLDER M.D.
NPI 1124818067
Student in an Organized Health Care Education/Training Program in Charleston, WV

Q: What is Shaniah Holder's NPI number?

The NPI number for Shaniah Holder is 1124818067. It was assigned to this individual provider in the NPPES registry on May 12, 2025.

Q: What is Shaniah Holder's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Shaniah Holder was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 12, 2025PECOS Enrolled

3200 MACCORKLE AVE SE, CHARLESTON, WV 25304(304) 388-5590(304) 388-8238 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 13, 2025, May 12, 2025 (2 updates tracked since 2025).

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About Shaniah Shontae Holder M.d. NPPES

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

SHANIAH SHONTAE HOLDER M.D. (NPI 1124818067) is an individual student in an organized health care education/training program in Charleston, West Virginia and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124818067

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameSHANIAH SHONTAE HOLDERCredential: M.D.

Location Address3200 MACCORKLE AVE SECharleston, WV 25304

Mailing Address3200 Maccorkle Ave SeCharleston, WV 25304 · (304) 388-5590 · Fax (304) 388-8238

Phone(304) 388-5590

Fax(304) 388-8238

Sole ProprietorNo

Enumeration DateMay 12, 2025

Last NPPES UpdateAugust 13, 20252 updates tracked since enumeration

✔ NPI 1124818067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3200 MACCORKLE AVE SE, Charleston, WV 25304

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shaniah Shontae Holder M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

CAMERON DUBA DO

Emergency Medicine

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 388-4172

WILLIAM JARRETT WISEMAN BSN, RN, CCRN-CMC

Registered Nurse

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 993-1088

MS. BRENDA LOU KEEFER ANP

Nurse Practitioner (Family)

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 925-3436

LOUISE NAYLOR

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE
CHARSTON, WV 25304

Kanawha County (304) 388-4077

DR. JEFFREY V ASHLEY M.D.

Family Medicine

3200 MACCORKLE AVE SE, FIFTH FLOOR
CHARLESTON, WV 25304

Kanawha County (304) 388-4600

TIFFANY D. DUTTON CRNA

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE, DEPT. OF SURGERY
CHARLESTON, WV 25304

Kanawha County (304) 388-5503

JENNIFER D VALDEZ

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 388-5432

CHRISTOPHER S MULLINS

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 688-0228

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shaniah Holder's NPI number?

The NPI number for Shaniah Holder is 1124818067. It was assigned to this individual provider in the NPPES registry on May 12, 2025.

Where is Shaniah Holder located?

Shaniah Holder practices at 3200 Maccorkle Ave SE, Charleston, WV 25304. The listed phone number is (304) 388-5590.

What is Shaniah Holder's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shaniah Holder enrolled in Medicare?

Yes. Shaniah Holder is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shaniah Holder was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.