Keith A Poole, DO
Individual provider Active NPI Family Medicine Physician · Bridgeport, OH
NPI 1487609558 · NPPES record last updated Jul 15, 2022
Key facts
- NPI
- 1487609558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 34.007929 (OH)
- Practice address
- 55741 National Road
Bridgeport, OH 43912 - Phone
- (740) 635-4572
- Fax
- (740) 635-4575
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wheeling Hospital Inc
Practice addresses (Care Compare)
1025 Market St
Wheeling, WV 26003-2944
Phone (304) 231-2104
51339 National Rd
Saint Clairsville, OH 43950-9119
Phone (740) 695-1210
Hospital & facility affiliations
- Stonerise at Home
- Wvuhs Home Care
- Wheeling Hospital, Inc
- Harrison Community Hospital
- Wetzel County Hospital
- Reynolds Memorial Hospital, Inc
- Barnesville Hospital Association, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.34 of 100
- Quality
- 79.86
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH, WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110331000759 | OH | Practitioner - Family Practice | 0244413094 | Reassigns benefits to 1 organization |
| I20120213000121 | WV | Practitioner - Family Practice |
0244413094 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.007929 | OH | MD | Family Medicine Physician |
| 1840 | WV | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wheeling Hospital Inc | Current |
Accepting new patients | |
| Wheeling Hospital, Inc. | Family Medicine | Current |
Accepting new patients |
| Wheeling Hospital Inc | Family Medicine | Current |
Accepting new patients |
| Wheeling Hospital Inc | Past | Accepting new patients | |
| Wheeling Hospital, Inc. | Past | Accepting new patients |
Locations
4697 Harrison St
Bellaire, OH 43906
Phone (304) 234-2000
55741 National Rd
Bridgeport, OH 43912
Phone (740) 633-9922
222 N 5th St
Ste 101
Martins Ferry, OH 43935
Phone (740) 633-6480
63 Highway 7 S
Powhatan Pt, OH 43942
Phone (740) 795-4505
51339 National Rd
St Clairsvle, OH 43950
Phone (740) 695-1210
3 E Benjamin Dr
North Martinsvlle, WV 26155
Phone (304) 455-8000
3 E Benjamin Dr
Ste B
North Martinsvlle, WV 26155
Phone (304) 455-6003
1025 Market St
Wheeling, WV 26003
Phone (304) 231-2104
1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124
Interoperability endpoints
- kpoole307713@direct.wvuhsdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1840 | WV | |
| Family Medicine Physician | 207Q00000X | 34.007929 | OH | Yes |
Addresses
Primary practice location
55741 National Road
Bridgeport, OH 43912
Mailing address
51339 National Rd
Saint Clairsville, OH 43950-9119
Phone (740) 635-4572
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841034000 | Medicaid | WV | |
| 2345144 | Medicaid | OH |
Other providers in Bridgeport, OH
- Leondre Nightengale
- Ohio Valley Sports and Physical Therapy LLC
- Joyce A Owens
- Patriot Medical Supplies Inc
- Mary Ann Planey
- Precision Anesthesia Services, LLC
- Riesbeck Food Markets, Inc.
- Domenique Evette Riggle
- Ronald Landau, MD, Inc.
- Bethany Dawn Scarry
All providers in Bridgeport, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.