Individual provider Active NPI

Jennifer A Pumphrey, MD

  • Pediatrics Physician
  • Kingwood, WV
National Provider Identifier
1114041803
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20737 Issued in WV
Practice address
150 Memorial Dr
Kingwood, WV 26537-1141
Phone
(304) 329-1400
Fax
(304) 329-1175
NPI assigned
Mar 19, 2007
Last updated
May 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20737 WV Primary

Addresses

Primary practice location

150 Memorial Dr
Kingwood, WV 26537-1141

Mailing address

150 Memorial Dr
Kingwood, WV 26537-1141
Phone (304) 329-1400

Other identifiers 1

IdentifierTypeStateIssuer
1840388000MedicaidWV

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050315000533 WV Practitioner - Pediatric Medicine 9133174972 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20737WVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Memorial Hospital Corporation CurrentSince Apr 1, 2013 Accepting new patients
Preston Memorial Hospital Corporation CurrentSince Apr 1, 2013 Accepting new patients
Preston Memorial Medical Group Past Accepting new patients

Locations

110 N Price St
Kingwood, WV 26537
Phone (304) 329-3500

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

428 Morgantown St
Ste 2
Kingwood, WV 26537
Phone (304) 329-0256

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/preston-adacdb24

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.

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": "1590710400000",
    "number": "1114041803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MEMORIAL DR",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371141",
            "telephone_number": "304-329-1400",
            "fax_number": "304-329-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MEMORIAL DR",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371141",
            "telephone_number": "304-329-1400",
            "fax_number": "304-329-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUMPHREY",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "20737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1840388000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, WV

Sources for this page

Verify at the official NPI Registry.