Individual provider Active NPI

Leigh Ann Walters, PA-C

  • Physician Assistant
  • Moorefield, WV
National Provider Identifier
1396990909
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
01380 Issued in WV
Practice address
8 Lee Street
Potomac Valley Family Medicine
Moorefield, WV 26836
Phone
(304) 538-7707
Fax
(304) 538-7706
NPI assigned
Nov 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 01380 WV Primary

Addresses

Primary practice location

8 Lee Street
Potomac Valley Family Medicine
Moorefield, WV 26836

Mailing address

1951 Pine Ridge Rd
Wardensville, WV 26851-8428
Phone (304) 897-7003

Other identifiers 1

IdentifierTypeStateIssuer
3810013836MedicaidWV

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
I20090408000351 WV Practitioner - Physician Assistant 7810044898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valeo Medical PLLCGroup PAC ID 5597806471, 19 clinicians

Practice addresses (Care Compare)

260 Russell Ave
New Martinsville, WV 26155-1571
Phone (304) 398-4949

747 N Main St C
Moorefield, WV 26836-1336
Phone (304) 538-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01380WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care of West Virginia, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1396990909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 PINE RIDGE RD",
            "city": "WARDENSVILLE",
            "state": "WV",
            "postal_code": "268518428",
            "telephone_number": "304-897-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 LEE STREET",
            "address_2": "POTOMAC VALLEY FAMILY MEDICINE",
            "city": "MOOREFIELD",
            "state": "WV",
            "postal_code": "26836",
            "telephone_number": "304-538-7707",
            "fax_number": "304-538-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "LEIGH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810013836",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorefield, WV

Sources for this page

Verify at the official NPI Registry.