Individual provider Active NPI

Gordon F Prescott, MD

  • Specialist
  • Princeton, WV
National Provider Identifier
1215042593
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
10242 Issued in WV
Practice address
508 New Hope Rd Ste 7
Princeton, WV 24740
Phone
(304) 431-7200
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 10242 WV Primary

Addresses

Primary practice location

508 New Hope Rd Ste 7
Princeton, WV 24740

Mailing address

118 12TH Street Ext
Princeton, WV 24740-2352
Phone (304) 487-7936

Other practice location 1

100 New Hope Rd Ste 7
Princeton, WV 24740-2143
Phone (304) 487-1431

Other identifiers 1

IdentifierTypeStateIssuer
0080053000MedicaidWV

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
I20100802000820 WV Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 7416080130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Tufts University School of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton Community Hospital Assn. Inc.Group PAC ID 3678482221, 174 clinicians

Practice addresses (Care Compare)

120 12TH St Ext
Princeton, WV 24740-2352
Phone (304) 487-8000

401 E Vermillion St
Athens, WV 24712-8005
Phone (304) 384-7325

Hospital & facility affiliations

  • Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10242WVMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Community Hospital Assn Inc. CurrentSince Aug 9, 2015 Accepting new patients
Princeton Community Hospital Assn., Inc CurrentSince Aug 9, 2015 Accepting new patients
Joseph a Dicristofaro Past Accepting new patients
Integrated Health Care Providers Past Accepting new patients

Locations

401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325

118 12th Street Ext
Princeton, WV 24740
Phone (304) 425-9568

508 New Hope Rd
Ste 7
Princeton, WV 24740
Phone (304) 425-0403

Organizations & group practices 4

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1215042593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402352",
            "telephone_number": "304-487-7936",
            "fax_number": "304-487-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 NEW HOPE RD STE 7",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "24740",
            "telephone_number": "304-431-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 New Hope Rd Ste 7",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "WV",
            "postal_code": "247402143",
            "country_code": "US",
            "telephone_number": "304-487-1431",
            "fax_number": "304-425-5813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "GORDON",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "10242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080053000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.