Individual provider Active NPI

Jennifer Anne Taylor, PA

  • Physician Assistant
  • Wheeling, WV
National Provider Identifier
1396896080
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00398 Issued in WV
Practice address
1 Medical Park
Suite 704
Wheeling, WV 26003
Phone
(304) 243-3134
Fax
(304) 243-3824
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50000749 OH
Physician Assistant 363A00000X 00398 WV Primary
Physician Assistant 363A00000X 50000749 OH
Surgical Physician Assistant 363AS0400X 00398 WV

Addresses

Primary practice location

1 Medical Park
Suite 704
Wheeling, WV 26003

Mailing address

1 Medical Park
Suite 704
Wheeling, WV 26003
Phone (304) 243-3134

Other identifiers 1

IdentifierTypeStateIssuer
0119655MedicaidOH

Other names 1

  • Jennifer Anne Sampson Other name

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
I20040621000329 WV Practitioner - Physician Assistant 6507841046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

1 Medical Park
Wheeling, WV 26003-6300

1 Medical Park
Wheeling, WV 26003-6379

Hospital & facility affiliations

  • Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050
  • Barnesville Hospital Association, Inc Hospital, Barnesville, OH, CCN 361321
  • Reynolds Memorial Hospital, Inc Hospital, Glen Dale, WV, CCN 510013

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50000749OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital Inc CurrentSince Mar 29, 2010 Accepting new patients
Wheeling Hospital, Inc. Past Accepting new patients
Wheeling Hospital Inc Past Accepting new patients

Locations

68 State Route 7
Bridgeport, OH 43912
Phone (740) 676-6600

90 N 4th St
Martins Ferry, OH 43935
Phone (304) 234-8425

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

76 16th St
Wheeling, WV 26003
Phone (304) 238-0212

1 Medical Park
Ste 704
Wheeling, WV 26003
Phone (304) 243-3134

76 16th St
Ste 100
Wheeling, WV 26003
Phone (304) 238-0212

40 Medical Park
Ste 203
Wheeling, WV 26003
Phone (304) 243-3134

2000 Eoff St
Wheeling, WV 26003
Phone (304) 234-0123

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1396896080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK",
            "address_2": "SUITE 704",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-243-3134",
            "fax_number": "304-243-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK",
            "address_2": "SUITE 704",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-243-3134",
            "fax_number": "304-243-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50000749",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "00398",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50000749",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "00398",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119655",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SAMPSON",
            "middle_name": "ANNE",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.