Jaclyn L Fitchett, PPCNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

69696 Issued in WV

Practice address

1 Medical Center Drive
Morgantown, WV 26506-7911

Phone

(304) 598-4800

NPI assigned

Oct 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jaclyn L Paugh Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• West Virginia University Medical Corporation

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508
  Medicare reassignment NPD
• West Virginia University Medical Corporation

  • Community/Behavioral Health Agency
  • Martinsburg, WV
  • NPI 1174233530
  NPD
• Wvu Medical Corporation

  • Neurological Surgery Physician
  • Bridgeport, WV
  • NPI 1245625581
  NPD

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1124303128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780",
            "telephone_number": "304-293-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265067911",
            "telephone_number": "304-598-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCHETT",
        "first_name": "JACLYN",
        "middle_name": "L",
        "credential": "PPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WV",
            "license": "69696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "PAUGH",
            "middle_name": "L",
            "credential": "PPCNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melanie A Fisher, M. D.
• Samuel Grafton Fisher, LMT
• Taylor Lane Fisher, M.D.
• Felicity Fisk, M.D.
• Amy Fiske, PH.D.
• Carmalyn Fitz
• Brody Fitzpatrick, MD
• Karen M Fitzpatrick, M.D.
• Allison Flanagan, MD
• Keele Flanigan

• Pediatric Nurse Practitioner in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Pediatric Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.