Individual provider Active NPI

Jessica Elaine Wooten, FNP-BC

  • Family Nurse Practitioner
  • Ravenswood, WV
National Provider Identifier
1245510494
Registry record updated Sep 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
73097 Issued in WV
Practice address
606 Washington St
Ravenswood, WV 26164-1730
Phone
(304) 273-1033
Fax
(304) 273-1034
NPI assigned
Aug 19, 2011
Last updated
Sep 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 73097 WV Primary

Addresses

Primary practice location

606 Washington St
Ravenswood, WV 26164-1730

Mailing address

606 Washington St
Ravenswood, WV 26164-1730
Phone (304) 273-1033

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
I20120106000803 WV Practitioner - Nurse Practitioner 8628244951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

800 Garfield Ave
Parkersburg, WV 26101-5376
Phone (304) 424-2111

800 Grand Central Mall
Vienna, WV 26105-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73097WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wirt County Health Services Association Inc CurrentSince Nov 13, 2011 Accepting new patients
Wirt County Health Services Association, Inc Current Accepting new patients
Wirt County Health Services Association, Inc Current Accepting new patients
Camden-Clark Physician Corporation CurrentSince Apr 1, 2023 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

483 Court St
Elizabeth, WV 26143
Phone (304) 275-3301

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

606 Washington St
Ravenswood, WV 26164
Phone (304) 273-1033

512A Church St S
Ripley, WV 25271
Phone (304) 372-1033

800 Grand Central Mall
Ste 4
Vienna, WV 26105
Phone (304) 485-3300

Organizations & group practices 5

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 4

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": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1245510494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 WASHINGTON ST",
            "city": "RAVENSWOOD",
            "state": "WV",
            "postal_code": "261641730",
            "telephone_number": "304-273-1033",
            "fax_number": "304-273-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 WASHINGTON ST",
            "city": "RAVENSWOOD",
            "state": "WV",
            "postal_code": "261641730",
            "telephone_number": "304-273-1033",
            "fax_number": "304-273-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "JESSICA",
        "middle_name": "ELAINE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "73097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenswood, WV

Sources for this page

Verify at the official NPI Registry.