Jacqueline Elizabeth McCarty, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

544 Issued in WV

Practice address

4815 Kanawha Ave SW
South Charleston, WV 25309-1207

Phone

(304) 768-4567

Fax

(304) 768-2277

NPI assigned

Sep 14, 2011

Last updated

Mar 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Elizabeth Moore Former name

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain State Medical Specialties PLLCGroup PAC ID 9335046754, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029

Merit-based Incentive Payment System (MIPS)

Final score

90.43 of 100Reported as group

Quality

88.74

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jmoore@msms.emadirect.md

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.

• Mountain State Medical Specialties, PLLC

  • Dermatology Physician
  • Bridgeport, WV
  • NPI 1891892097
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Herbert J. Thomas Memorial Hospital Association

  dba Thomas Memorial Hospital

  • General Acute Care Hospital
  • South Charleston, WV
  • NPI 1316925506
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1295017473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 KANAWHA AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091207",
            "telephone_number": "304-545-8790",
            "fax_number": "304-768-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 KANAWHA AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091207",
            "telephone_number": "304-768-4567",
            "fax_number": "304-768-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTY",
        "first_name": "JACQUELINE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "MOORE",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica L McCallister
• Julie N McCallister, MD
• Kandi Michelle Ann McCallister
• Sherry McCallister
• Tiffany McCallister
• Taylor Rose McClary
• Alexandria McCloud
• Farrah McClung
• Morgan McClung, FNP-BC
• Lisa Marie McClure, FNP-C

• Medical Physician Assistant in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.