Individual provider Active NPI

Jonathan Robert Metke, PA

  • Physician Assistant
  • Kingwood, WV
National Provider Identifier
1417796723
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1001 Army Rd
Kingwood, WV 26537-7515
Phone
(304) 791-4040
NPI assigned
May 24, 2024
Last updated
Jan 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0008857 CO
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1001 Army Rd
Kingwood, WV 26537-7515

Mailing address

1001 Army Rd
Kingwood, WV 26537-7515
Phone (304) 791-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20250211001845 CO Practitioner - Physician Assistant 0941730659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2767 Janitell Rd
Colorado Springs, CO 80906-4102
Phone (719) 365-2888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0008857COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Specialists, PC CurrentSince Jan 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Mar 9, 2026 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1035 Garden of the Gods Rd
Ste 120
Colorado Springs, CO 80907
Phone (719) 329-1000

13445 Voyager Pkwy
Colorado Springs, CO 80921
Phone (719) 219-0333

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

2767 Janitell Rd
Colorado Springs, CO 80906
Phone (719) 365-2888

4050 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 364-5000

4323 Integrity Center Pt
Colorado Springs, CO 80917
Phone (719) 591-2558

11605 Meridian Market Vw
Ste 184
Peyton, CO 80831
Phone (719) 364-9555

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1417796723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ARMY RD",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265377515",
            "telephone_number": "304-791-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ARMY RD",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265377515",
            "telephone_number": "304-791-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METKE",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-24",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008857",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, WV

Sources for this page

Verify at the official NPI Registry.