Active NPI
Kathryn S Moffett, M.D.
- Pediatric Infectious Diseases Physician
- Morgantown, WV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Infectious Diseases Physician
- License
- 19570
- Practice address
- 1 Stadium Drive
Morgantown, WV 26506 - Phone
- (304) 598-4800
- Fax
- (304) 598-6061
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 19570 | WV | |
| Pediatric Infectious Diseases Physician | 2080P0208X | 19570 | WV | Primary |
Addresses
Primary practice location
1 Stadium Drive
Morgantown, WV 26506
Mailing address
PO Box 897
Morgantown, WV 26507-0897
Phone (304) 293-7401
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0111774000 | Medicaid | WV |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kmoffett573@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | kmoffett573@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | kmoffett573@direct.wvuhsdirect.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19570 | WV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Virginia University Medical Corporation | Pediatrics | Current | Accepting new patients |
| West Virginia University Medical Corporation | Current | Accepting new patients | |
| Wvu Medical Corporation | Pediatrics | Current | Accepting new patients |
Locations
1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Harpers Ferry Family Medicine | Rural health clinic | Corporate Director | Jan 1, 2023 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba University Health Associates
- Family Medicine Physician
- Morgantown, WV
- NPI 1275504508
Corporate Director
Organizations & group practices 3
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.
-
dba University Health Associates
- Family Medicine Physician
- Morgantown, WV
- NPI 1275504508
Pediatrics
-
dba Crisis Support and Recovery Center
- Community/Behavioral Health Agency
- Martinsburg, WV
- NPI 1174233530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649808000000",
"number": "1023132750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 897",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265070897",
"telephone_number": "304-293-7401",
"fax_number": "304-293-6963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 STADIUM DRIVE",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "26506",
"telephone_number": "304-598-4800",
"fax_number": "304-598-6061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOFFETT",
"first_name": "KATHRYN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2022-04-13",
"certification_date": "2022-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WV",
"license": "19570",
"primary": false
},
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "WV",
"license": "19570",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0111774000",
"state": "WV"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kmoffett573@direct.wvuhsdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1 Medical Center Dr",
"city": "Morgantown",
"state": "WV",
"country_code": "US",
"postal_code": "265061200",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kmoffett573@direct.wvuhsdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1 Medical Center Dr",
"city": "Morgantown",
"state": "WV",
"country_code": "US",
"postal_code": "265061200",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kmoffett573@direct.wvuhsdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1 Medical Center Dr",
"city": "Morgantown",
"state": "WV",
"country_code": "US",
"postal_code": "265061200",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.