Individual provider Active NPI

Kristin Indermuhle, NP-C

  • Nurse Practitioner
  • Morgantown, WV
National Provider Identifier
1205314564
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
88980 Issued in WV
Practice address
205 Bakers Ridge Rd
Morgantown, WV 26508-1500
Phone
(304) 598-4285
NPI assigned
Jul 30, 2018
Last updated
Apr 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 88980 WV Primary

Addresses

Primary practice location

205 Bakers Ridge Rd
Morgantown, WV 26508-1500

Mailing address

205 Bakers Ridge Rd
Morgantown, WV 26508-1500
Phone (304) 598-4285

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address kwendell26880@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address kwendell26880@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address kwendell26880@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address kwendell26880@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190213000012 WV Practitioner - Nurse Practitioner 9638417967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

205 Bakers Ridge Rd
Morgantown, WV 26508-1500
Phone (304) 598-4285

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
88980WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Aug 15, 2018 Accepting new patients
West Virginia University Medical Corporation Current Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 15, 2018 Accepting new patients

Locations

100 Stoney Hill Rd
Fairmont, WV 26554
Phone (304) 285-5400

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

205 Bakers Ridge Rd
Morgantown, WV 26508
Phone (304) 598-4285

Interoperability endpoints

  • Direct secure messaging: kwendell26880@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, 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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1205314564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BAKERS RIDGE RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081500",
            "telephone_number": "304-598-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BAKERS RIDGE RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081500",
            "telephone_number": "304-598-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDERMUHLE",
        "first_name": "KRISTIN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "88980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwendell26880@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "205 Bakers Ridge Rd",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265081500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwendell26880@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "205 Bakers Ridge Rd",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265081500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwendell26880@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "205 Bakers Ridge Rd",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265081500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwendell26880@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "205 Bakers Ridge Rd",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265081500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.