Individual provider Active NPI

Kristin R Youther, FNP-BC

  • Family Nurse Practitioner
  • Princeton, WV
National Provider Identifier
1265797724
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
58892 Issued in WV
Practice address
702 Stafford Dr
Princeton, WV 24740-2406
Phone
(304) 425-0085
Fax
(304) 487-6993
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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 58892 WV Primary

Addresses

Primary practice location

702 Stafford Dr
Princeton, WV 24740-2406

Mailing address

702 Stafford Dr
Princeton, WV 24740-2406
Phone (304) 425-0085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130529000635 WV Practitioner - Nurse Practitioner 7517105786 Reassigns benefits to 1 organization
I20170522002357 VA Practitioner - Nurse Practitioner 7517105786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Care 12 Priority Health IncGroup PAC ID 8325410855, 2 clinicians

Practice addresses (Care Compare)

702 Stafford Dr
Princeton, WV 24740-2406
Phone (304) 425-0085

Hospital & facility affiliations

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Virginia CurrentSince Feb 25, 2017 Accepting new patients
Medexpress Urgent Care, PC - Virginia CurrentSince Feb 25, 2017 Accepting new patients
Prime Care 12 Priority Health Inc. CurrentSince Jan 1, 2025 Accepting new patients
East River Medical, PLLC Family Past Accepting new patients
Prime-Care 12, Inc PastSince Jan 1, 2025 Accepting new patients

Locations

4003 College Ave
#B
Bluefield, VA 24605
Phone (276) 322-2085

1336 W Main St
Salem, VA 24153
Phone (540) 389-0374

423 Fortress Blvd
Morgantown, WV 26508
Phone (844) 852-9510

702 Stafford Dr
Princeton, WV 24740
Phone (304) 425-0085

Interoperability endpoints

  • Direct secure messaging: kyouther@primecare12.directbygreenway.com
  • Direct secure messaging: kryouthe@yourcarecommunity.org

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 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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1265797724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 STAFFORD DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402406",
            "telephone_number": "304-425-0085",
            "fax_number": "304-487-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 STAFFORD DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402406",
            "telephone_number": "304-425-0085",
            "fax_number": "304-487-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUTHER",
        "first_name": "KRISTIN",
        "middle_name": "R",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "58892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.