Individual provider Active NPI

Kristi M Lafferty, CRNP

  • Family Nurse Practitioner
  • Parkersburg, WV
National Provider Identifier
1427169408
Registry record updated Aug 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
50679 Issued in WV
Practice address
417 Grand Park Dr Ste 106
Parkersburg, WV 26105-4049
Phone
(304) 842-3341
Fax
(304) 842-2339
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2019

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 50679 WV Primary

Addresses

Primary practice location

417 Grand Park Dr Ste 106
Parkersburg, WV 26105-4049

Mailing address

106B Cambridge PL
Bridgeport, WV 26330-2812
Phone (304) 842-3341

Other identifiers 2

IdentifierTypeStateIssuer
7103093000MedicaidWV
2633814MedicaidOH

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
I20051213000917 WV Practitioner - Nurse Practitioner 6800817222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

107 B Cambridge PL
Bridgeport, WV 26330-2812
Phone (304) 842-3341

107 Cambridge PL
Suite B
Bridgeport, WV 26330-2812

124 Chenoweth Creek Rd
Elkins, WV 26241-9795
Phone (304) 842-3341

21 Auction LN
Buckhannon, WV 26201-8968
Phone (304) 842-3341

230 Hospital PLZ
Weston, WV 26452-8558
Phone (304) 842-3341

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
66.2 of 100Reported as individual
Quality
48.37
Promoting interoperability
82
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50679WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Outreach, LLC Family CurrentSince Oct 1, 2010 Accepting new patients
James J. Demarco M.D. Past Accepting new patients
Ags Inc Past Accepting new patients

Locations

4800 State Route 60
Marietta, OH 45750
Phone (740) 374-2597

107 Cambridge Pl
#B
Bridgeport, WV 26330
Phone (304) 842-3341

106B Cambridge Pl
Bridgeport, WV 26330
Phone (304) 842-3341

107 Cambridge Pl
Ste B
Bridgeport, WV 26330

111 State St
Bridgeport, WV 26330
Phone (304) 842-3341

21 Auction Ln
Buckhannon, WV 26201
Phone (304) 472-0245

124 Chenoweth Creek Rd
Elkins, WV 26241
Phone (304) 460-7948

417 Grand Park Dr
Ste 106
Parkersburg, WV 26105
Phone (304) 842-3341

800 Northside Dr
Summersville, WV 26651
Phone (304) 842-3341

230 Hospital Plz
Weston, WV 26452
Phone (304) 269-8000

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 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566000000000",
    "number": "1427169408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106B CAMBRIDGE PL",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263302812",
            "telephone_number": "304-842-3341",
            "fax_number": "304-842-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 GRAND PARK DR STE 106",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261054049",
            "telephone_number": "304-842-3341",
            "fax_number": "304-842-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFFERTY",
        "first_name": "KRISTI",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "50679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7103093000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2633814",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.