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ETHAN SHAMUS LAFFERTY DDS
NPI 1285087494
Dentist in Bluefield, WV

Active since July 22, 2016PECOS Enrolled
1321 STADIUM DR, BLUEFIELD, WV 24701(304) 327-7135(304) 327-0758 Get Directions Write a Review

NPPES record last updated: September 21, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Ethan Shamus Lafferty Dds NPPES

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

ETHAN SHAMUS LAFFERTY DDS (NPI 1285087494) is an individual dentist in Bluefield, West Virginia, licensed in West Virginia (4224) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285087494
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameETHAN SHAMUS LAFFERTYCredential: DDS
Location Address1321 STADIUM DRBluefield, WV 24701-3318
Mailing Address1321 Stadium DrBluefield, WV 24701-3318 · (304) 327-7135 · Fax (304) 327-0758
Phone(304) 327-7135
Fax(304) 327-0758
Sole ProprietorYes
Enumeration DateJuly 22, 2016
Last NPPES UpdateSeptember 21, 2023
NPPES CertifiedSeptember 20, 2023
✔ NPI 1285087494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in WV · 4224
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1321 STADIUM DR, Bluefield, WV 24701
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Ohio, Inc., BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Shamus Lafferty Dds 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.

Medicare Billing Reassignment

Medicare enrollment records show Ethan Lafferty reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Rainelle Medical Center, Inc.
62 mi
Federally Qualified Health Center (FQHC)
390 INDUSTRIAL PARK
Maxwelton, WV 24957
  • Reassigned Medicare billing, West Virginia enrollment
  • 55 clinicians in this Medicare group
NPI 1528417946 (304) 438-6188

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

ETHAN LAFFERTY, DDS, PLLC
Dentist (General Practice)
1321 STADIUM DR
BLUEFIELD, WV 24701
Mercer County (304) 327-7135
DR. HAROLD LEE GOFORTH JR. D.D.S.
Dentist (General Practice)
1321 STADIUM DR
BLUEFIELD, WV 24701
Mercer County (304) 327-7135

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 Ethan Lafferty's NPI number?

The NPI number for Ethan Lafferty is 1285087494. It was assigned to this individual provider in the NPPES registry on July 22, 2016.

Where is Ethan Lafferty located?

Ethan Lafferty practices at 1321 Stadium Dr, Bluefield, WV 24701. The listed phone number is (304) 327-7135.

What is Ethan Lafferty's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Ethan Lafferty enrolled in Medicare?

Yes. Ethan Lafferty is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ethan Lafferty's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Lafferty reassigns Medicare benefits to Rainelle Medical Center, Inc. (Maxwelton, WV). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethan Lafferty's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ethan Lafferty accept?

Health plans from Antidote Health Plan of Ohio, Inc., BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 3 other insurers list Ethan Lafferty as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ethan Lafferty was last updated on September 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.