Jacqueline J Ross, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

0991 Issued in WV

Practice address

1 Diane Dr
Fort Ashby, WV 26719-0686

Phone

(304) 298-3602

NPI assigned

Mar 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Complete Care at Dawnview LLC

  • Skilled Nursing Facility
  • Fort Ashby, WV
  • NPI 1760057012
  NPD (past)
• Complete Care at Dawnview LLC

  • Skilled Nursing Facility
  • Fort Ashby, WV
  • NPI 1801470463
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003940297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 686",
            "city": "FORT ASHBY",
            "state": "WV",
            "postal_code": "267190686",
            "telephone_number": "304-298-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DIANE DR",
            "city": "FORT ASHBY",
            "state": "WV",
            "postal_code": "267190686",
            "telephone_number": "304-298-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JACQUELINE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "0991",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A2724",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASSIT",
            "identifier": "A2724",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASSIST",
            "identifier": "0991",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ginger R Paugh
• Potomac Valley Hospital of W VA , Inc
• Potomac Valley Hospital of W VA , Inc
• Julie Robertson
• Kloey R Robinette
• Same (Association of Psychological and Psychiatric Services)
• Savalot Phcy of Ft Ashby Inc (Savalot Pharmacy of Ft Ashby Inc)
• Angela Saville
• Travis Senn
• Brandy Louise Shoemaker

• Physical Therapy Assistant in Fort Ashby, WV
• Providers in Fort Ashby, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.