Individual provider Active NPI

Jordan Rine, PH.D.

  • Clinical Neuropsychologist
  • Martinsburg, WV
National Provider Identifier
1144110255
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6729 Issued in NC
Practice address
61 Campus Dr
Martinsburg, WV 25404-7542
Phone
(209) 612-7443
NPI assigned
Jul 9, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6729 NC Primary

Addresses

Primary practice location

61 Campus Dr
Martinsburg, WV 25404-7542

Mailing address

13605 Sloan St
Rockville, MD 20853-2554
Phone (209) 612-7443

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250913000192 WV Practitioner - Clinical Psychologist 6507369683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

61 Campus Dr
Suite 300
Martinsburg, WV 25404-7542
Phone (304) 264-0704

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6729NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Sep 29, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Sep 29, 2025 Accepting new patients

Locations

2004 Professional Ct
Martinsburg, WV 25401
Phone (304) 263-8964

61 Campus Dr
Martinsburg, WV 25404
Phone (304) 274-6343

61 Campus Dr
Ste 300
Martinsburg, WV 25404
Phone (304) 264-0704

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1144110255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13605 SLOAN ST",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208532554",
            "telephone_number": "209-612-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 CAMPUS DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254047542",
            "telephone_number": "209-612-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINE",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NC",
            "license": "6729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.