Individual provider Active NPI

Jo Ann Longenecker, M.D.

  • Family Medicine Physician
  • Clarksburg, WV
National Provider Identifier
1548359193
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15551 Issued in WV
Practice address
2673 Davisson Run Rd Ste 101
Clarksburg, WV 26301-6838
Phone
(681) 342-3470
Fax
(304) 622-6109
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15551 WV Primary

Addresses

Primary practice location

2673 Davisson Run Rd Ste 101
Clarksburg, WV 26301-6838

Mailing address

2324 Hawk Highway
Lost Creek, WV 26385-9707
Phone (304) 745-3200

Other practice location 1

2324 Hawk Highway
Lost Creek, WV 26385-9707
Phone (304) 745-3200

Other identifiers 1

IdentifierTypeStateIssuer
0041652000MedicaidWV

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jlongenecker3965@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address jlongenecker3965@direct.wvuhsdirect.com Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120111000230 WV Practitioner - Family Practice 1254508450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Physicians Care IncGroup PAC ID 6103814017, 119 clinicians

Practice addresses (Care Compare)

2673 Davisson Run Rd
Suite 101
Clarksburg, WV 26301-6838
Phone (681) 342-3470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.61 of 100Reported as group
Quality
81.19
Promoting interoperability
100
Improvement activities
40
Cost
76.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15551WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Physicians Care Inc Family Medicine CurrentSince Jul 16, 2018 Accepting new patients
United Physicians Care Inc Family Medicine CurrentSince Jul 16, 2018 Accepting new patients

Locations

1370 Johnson Ave
Ste 102
Bridgeport, WV 26330
Phone (681) 342-3452

2673 Davisson Run Rd
Ste 101
Clarksburg, WV 26301
Phone (304) 623-1234

626 Elk St
Gassaway, WV 26624
Phone (304) 364-2401

2373 W Main St
Ste 102
Salem, WV 26426
Phone (304) 782-2000

Interoperability endpoints

  • Direct secure messaging: jlongenecker3965@direct.wvuhsdirect.com

Organizations & group practices 2

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 4

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1548359193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2324 HAWK HIGHWAY",
            "city": "LOST CREEK",
            "state": "WV",
            "postal_code": "263859707",
            "telephone_number": "304-745-3200",
            "fax_number": "304-745-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2673 DAVISSON RUN RD STE 101",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263016838",
            "telephone_number": "681-342-3470",
            "fax_number": "304-622-6109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2324 Hawk Highway",
            "address_purpose": "LOCATION",
            "city": "Lost Creek",
            "state": "WV",
            "postal_code": "263859707",
            "country_code": "US",
            "telephone_number": "304-745-3200",
            "fax_number": "304-745-4068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONGENECKER",
        "first_name": "JO",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "15551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0041652000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlongenecker3965@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2673 Davisson Run Rd Ste 101",
            "city": "Clarksburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263016838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlongenecker3965@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2673 Davisson Run Rd",
            "city": "Clarksburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263016838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarksburg, WV

Sources for this page

Verify at the official NPI Registry.