Kristy Divelbliss, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

01216 Issued in WV

Practice address

99 Tavern Rd
Martinsburg, WV 25401-2890

Phone

(304) 263-4999

NPI assigned

Sep 22, 2006

Last updated

Oct 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shenandoah Valley Medical System,Inc.Group PAC ID 9739093097, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Berkeley Medical Center Hospital, Martinsburg, WV, CCN 510008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kristy.divelbliss.1@32629.direct.athenahealth.com

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.

• Shenandoah Valley Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Martinsburg, WV
  • NPI 1083617823
  Medicare reassignment Care Compare group
• Shenandoah Valley Medical System, Inc.

  dba Shenandoah Community Health South Middle

  • Federally Qualified Health Center (FQHC)
  • Martinsburg, WV
  • NPI 1235853144
  NPD
• Shenandoah Valley Medical System,Inc.

  • Federally Qualified Health Center (FQHC)
  • Charles Town, WV
  • NPI 1992904668
  NPD
• Shenandoah Valley Medical System, Inc.

  dba Shenandoah Community Health Widmyer Elementary

  • Federally Qualified Health Center (FQHC)
  • Berkeley Springs, WV
  • NPI 1568186153
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Shenandoah Valley Medical System, Inc.

  dba Winchester Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Winchester, VA
  • NPI 1023217452
  NPD (past)

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

• City Hospital, Inc

  dba Berkeley Medical Center

  • General Acute Care Hospital
  • Martinsburg, WV
  • NPI 1457389249
  Care Compare affiliation

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1497854517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1146",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254021146",
            "telephone_number": "304-263-4999",
            "fax_number": "304-264-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 TAVERN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012890",
            "telephone_number": "304-263-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVELBLISS",
        "first_name": "KRISTY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Lee Dillow
• Susan J Dilly, REGISTERED NURSE
• Kelly Dimmick
• Ha Dinh, M.D.
• Kristie Dinterman
• Diverse Counseling Solutions LLC (Diverse Counseling Solutions)
• Rosalind Diyanni, PLPC
• Kevin Louis Dobbins, O.D.
• Mercedes L Dockeney, CRNA
• Thomas A Dockman, MSW

• Physician Assistant in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.