Individual provider Active NPI

Stephanie Klemp, PRSS

  • Peer Specialist
  • Morgantown, WV
National Provider Identifier
1134857832
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
18-909 Issued in WV
Practice address
206 Spruce St
Morgantown, WV 26505-7539
Phone
(304) 413-4300
NPI assigned
Aug 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 18-909 WV Primary

Addresses

Primary practice location

206 Spruce St
Morgantown, WV 26505-7539

Mailing address

206 Spruce St
Morgantown, WV 26505-7539
Phone (304) 212-1379

Other identifiers 1

IdentifierTypeStateIssuer
18-909MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NA Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18-909WVMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Morgantown Sober Living, Inc. CurrentSince Aug 14, 2022 Accepting new patients
Ascension, LLC PastSince Aug 14, 2022 Accepting new patients

Locations

206 Spruce St
Morgantown, WV 26505
Phone (304) 413-4300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1134857832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 SPRUCE ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265057539",
            "telephone_number": "304-212-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 SPRUCE ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265057539",
            "telephone_number": "304-413-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMP",
        "first_name": "STEPHANIE",
        "credential": "PRSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WV",
            "license": "18-909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18-909",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "206 Spruce St",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265057539",
            "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 Aug 10, 2022; 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.