Individual provider Active NPI

Julie Smith

  • Family Nurse Practitioner
  • Kingwood, WV
National Provider Identifier
1184313140
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
117186 Issued in WV
Practice address
150 Memorial Dr
Kingwood, WV 26537-1141
Phone
(304) 329-1400
NPI assigned
May 4, 2023
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 102053 WV
Family Nurse Practitioner 363LF0000X 117186 WV Primary

Addresses

Primary practice location

150 Memorial Dr
Kingwood, WV 26537-1141

Mailing address

428 Morgantown St
Kingwood, WV 26537-1140
Phone (304) 329-0256

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231110001913 WV Practitioner - Nurse Practitioner 7214384395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preston Memorial Hospital CorporationGroup PAC ID 5294645107, shared by 3 NPIs, 46 clinicians

Practice addresses (Care Compare)

150 Memorial Dr
Kingwood, WV 26537-1141
Phone (304) 329-1400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102053WVMDRegistered Nurse
117186WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Memorial Hospital Corporation CurrentSince Sep 13, 2023 Accepting new patients
Preston Memorial Hospital Corporation CurrentSince Sep 13, 2023 Accepting new patients

Locations

428 Morgantown St
Ste 2
Kingwood, WV 26537
Phone (304) 329-0256

1001 Army Rd
Kingwood, WV 26537
Phone (304) 329-2118

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

110 N Price St
Kingwood, WV 26537
Phone (304) 329-3500

428 Morgantown St
Kingwood, WV 26537
Phone (304) 329-0256

12302 Veterans Memorial Hwy
Reedsville, WV 26547
Phone (304) 864-7393

12302 Veterans Memorial Hwy
Ste 4
Reedsville, WV 26547
Phone (304) 980-2006

2287 S Mountaineer Hwy
Thornton, WV 26440
Phone (304) 265-6963

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/preston-adacdb24

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 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": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1184313140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 MORGANTOWN ST",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371140",
            "telephone_number": "304-329-0256",
            "fax_number": "304-329-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MEMORIAL DR",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371141",
            "telephone_number": "304-329-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JULIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "102053",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "117186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, WV

Sources for this page

Verify at the official NPI Registry.