Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mariah Bacon

Individual provider Family Nurse Practitioner · NPI 1083459853

Mariah Bacon is a Nurse Practitioner in Shepherdstown, West Virginia. Qualified in 2023, 3 years ago. Practices with Valley Regional Enterprises, Inc, a 54-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
3
Licensed in
VA
In the registry since
2024

Practice location Address checks out

301 N King St
Shepherdstown, WV 25443
Phone: (304) 876-5000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 0024190164 (VA)

Record details

NPI number1083459853
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 25, 2024
Last updated in NPPESJune 25, 2024
Certification dateJune 14, 2024
Mailing address301 N King St., Shepherdstown, WV 25443

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Valley Regional Enterprises, Inc — 54 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Shepherdstown