NPIMap

Individual provider Active NPI

Jeremy David Cumberledge

  • Gastroenterology Physician
  • Charleston, WV
National Provider Identifier
1487912465
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
27042 Issued in WV
Practice address
3100 Maccorkle Ave SE Ste 500
Charleston, WV 25304-1226
Phone
(304) 342-0821
Fax
(304) 345-6679
NPI assigned
Apr 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 27042 WV Primary
Internal Medicine Physician 207R00000X 48215 KY

Addresses

Primary practice location

3100 Maccorkle Ave SE Ste 500
Charleston, WV 25304-1226

Mailing address

3100 Maccorkle Ave SE Ste 500
Charleston, WV 25304-1226
Phone (304) 342-0821

Other practice location 1

3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Other practice location 2

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Other practice location 3

1306 Kanawha Blvd E
Charleston, WV 25301-3001
Phone (304) 343-4371

Other practice location 4

800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone (304) 388-5432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191029001609 WV Practitioner - Gastroenterology 1759697022 Reassigns benefits to 1 organization
Practice locations: Charleston, WV

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
JC Edwards School of Medicine, Marshall University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charleston Area Medical Center IncGroup PAC ID 3375441637, 969 clinicians

Practice addresses (Care Compare)

1306 Kanawha Blvd E
Charleston, WV 25301-3001
Phone (304) 343-4371

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • Camc Charleston Surgical Hospital Hospital, Charleston, WV, CCN 510091
  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029
  • Camc Plateau Medical Center, Inc Hospital, Oak Hill, WV, CCN 511317
  • Logan Regional Medical Center Hospital, Logan, WV, CCN 510048

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
25.82 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
86.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy233
Upper gastrointestinal (GI) endoscopy for acid reflux254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48215KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Aug 18, 2019 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Aug 18, 2019 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Charleston Area Medical Center Inc PastSince Sep 25, 2019 Accepting new patients

Locations

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

3100 Maccorkle Ave SE
Ste 502
Charleston, WV 25304
Phone (304) 388-9335

3100 Maccorkle Ave SE
Ste 509
Charleston, WV 25304
Phone (304) 342-0821

3100 Maccorkle Ave SE
Ste 500
Charleston, WV 25304
Phone (304) 342-0703

1306 Kanawha Blvd E
Charleston, WV 25301
Phone (304) 343-4371

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

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 and National Provider Directory roles.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1487912465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 500",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041226",
            "telephone_number": "304-342-0821",
            "fax_number": "304-345-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 500",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041226",
            "telephone_number": "304-342-0821",
            "fax_number": "304-345-6679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041227",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1306 Kanawha Blvd E",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253013001",
            "country_code": "US",
            "telephone_number": "304-343-4371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253023351",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUMBERLEDGE",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-27",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WV",
            "license": "27042",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "48215",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.