Individual provider Active NPI

Stephanie A. Elmore, OT

  • Specialist
  • Ronceverte, WV
National Provider Identifier
1124217864
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1341 Issued in WV
Practice address
111 Davis Stuart Road
Ronceverte, WV 24970
Phone
(304) 647-3987
Fax
(304) 647-3990
NPI assigned
Oct 18, 2007
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenbrier Valley Physical Therapy LLC 57 clinicians

Practice addresses (Care Compare)

3942 Davis Stuart Rd
Suite 3
Ronceverte, WV 24970-0269
Phone (304) 647-3987

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
71.18
Promoting interoperability
92
Improvement activities
40
Cost
79.82

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20071116000203 WV Practitioner - Occupational Therapist in Private Practice 1951499425 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Valley Physical Therapy, LLC Current Accepting new patients
Greenbrier Valley Physical Therapy, LLC Specialist Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1341 WV Primary

Addresses

NPPES NPI Registry

Primary practice location

111 Davis Stuart Road
Ronceverte, WV 24970

Mailing address

111 Davis Stuart Road
Ronceverte, WV 24970
Phone (304) 647-3987

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
172V00000XMedicaidWV

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 25, 2023.

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1124217864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DAVIS STUART ROAD",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "24970",
            "telephone_number": "304-647-3987",
            "fax_number": "304-647-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DAVIS STUART ROAD",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "24970",
            "telephone_number": "304-647-3987",
            "fax_number": "304-647-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "STEPHANIE",
        "middle_name": "A.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "1341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172V00000X",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.