Individual provider Active NPI

Ruthanne M Watkins

  • Family Medicine Physician
  • Bridgeport, WV
National Provider Identifier
1174794069
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2378 Issued in WV
Practice address
1511 Johnson Ave
Bridgeport, WV 26330-1016
Phone
(681) 342-3700
Fax
(304) 848-0703
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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 2378 WV Primary

Addresses

Primary practice location

1511 Johnson Ave
Bridgeport, WV 26330-1016

Mailing address

1511 Johnson Ave
Bridgeport, WV 26330-1016
Phone (681) 342-3700

Other identifiers 1

IdentifierTypeStateIssuer
3810018332MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rwatkins23357@direct.wvuhsdirect.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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803000047 WV Practitioner - Family Practice 4486787124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Physicians Care IncGroup PAC ID 6103814017, 119 clinicians

Practice addresses (Care Compare)

1511 Johnson Ave
Suite 104
Bridgeport, WV 26330-1016
Phone (681) 342-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2378WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Physicians Care Inc Family Medicine CurrentSince Jan 2, 2013 Accepting new patients
United Physicians Care Inc Family Medicine CurrentSince Jan 2, 2013 Accepting new patients
Premier Medical Group, Inc. Family Medicine Past Accepting new patients

Locations

1511 Johnson Ave
Ste 104
Bridgeport, WV 26330
Phone (304) 848-0702

626 Elk St
Gassaway, WV 26624
Phone (304) 364-2401

2373 W Main St
Ste 102
Salem, WV 26426
Phone (304) 782-2000

Interoperability endpoints

  • Direct secure messaging: rwatkins23357@direct.wvuhsdirect.com

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.

Hospital & facility affiliations 2

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": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1174794069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 JOHNSON AVE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301016",
            "telephone_number": "681-342-3700",
            "fax_number": "304-848-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 JOHNSON AVE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301016",
            "telephone_number": "681-342-3700",
            "fax_number": "304-848-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "RUTHANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "2378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810018332",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwatkins23357@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1511 Johnson Ave",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263301016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.