NPIMap

Individual provider Active NPI

Debra R Crites-Sams, DO

  • Family Medicine Physician
  • Ronceverte, WV
National Provider Identifier
1154318632
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1139 Issued in WV
Practice address
1478 Maplewood Ave
Ronceverte, WV 24970-8017
Phone
(304) 645-4406
Fax
(304) 645-4492
NPI assigned
Sep 30, 2005
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1139 WV Primary

Addresses

Primary practice location

1478 Maplewood Ave
Ronceverte, WV 24970-8017

Mailing address

PO Box 465
Ronceverte, WV 24970-0465
Phone (304) 645-4406

Other identifiers 1

IdentifierTypeStateIssuer
0041844000MedicaidWV

Other names 1

  • Dr. Debra C Sams Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dcsamsdo@direct.practicefusion.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100312000078 WV Practitioner - Family Practice 1153456405 Practice locations: Ronceverte, WV

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H2 Rehabilitation Services of Virginia, LLCGroup PAC ID 1658280128, shared by 6 NPIs, 67 clinicians

Practice addresses (Care Compare)

1478 Maplewood Ave
Ronceverte, WV 24970-8017
Phone (304) 645-4406

320 W Main St
Covington, VA 24426-1517
Phone (540) 962-6226

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions21
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harron Neurosurgery, PC PastSince Dec 15, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dcsamsdo@direct.practicefusion.com
  • Direct secure messaging: dsams@gpi.gwaydirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1154318632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 465",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249700465",
            "telephone_number": "304-645-4406",
            "fax_number": "304-645-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 MAPLEWOOD AVE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708017",
            "telephone_number": "304-645-4406",
            "fax_number": "304-645-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITES-SAMS",
        "first_name": "DEBRA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0041844000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcsamsdo@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "EHR Direct Messaging  accepting HL7 Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1478 Maplewood Ave",
            "city": "Ronceverte",
            "state": "WV",
            "country_code": "US",
            "postal_code": "249708017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "SAMS",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ronceverte, WV

Sources for this page

Verify at the official NPI Registry.