Individual provider Active NPI

Kelly D Schoonover, PT

  • Physical Therapist
  • Fairmont, WV
National Provider Identifier
1558674697
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
002850 Issued in WV
Practice address
1509 Fairmont Ave
Fairmont, WV 26554-2135
Phone
(304) 363-0050
Fax
(304) 363-0048
NPI assigned
Jul 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 002850 WV Primary

Addresses

Primary practice location

1509 Fairmont Ave
Fairmont, WV 26554-2135

Mailing address

PO Box 6763
Wheeling, WV 26003-0918
Phone (304) 242-7106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100913000700 WV Practitioner - Physical Therapist in Private Practice 0042335119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
West Virginia University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elkins Physical Therapy Service IncGroup PAC ID 6305127358, 9 clinicians

Practice addresses (Care Compare)

1620 Harrison Ave
Elkins, WV 26241-8502
Phone (304) 636-2340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002850WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elkins Physical Therapy Service, Inc. Physical Therapist CurrentSince Mar 1, 2018 Accepting new patients
Orthopedic Physical Therapy Associates PastSince Jan 1, 2012 Accepting new patients
David a Lee Physical Therapist Past Accepting new patients
Hopebridge, LLC Physical Therapist Past Accepting new patients
Baird Physical Therapy Physical Therapist Past Accepting new patients

Locations

1035 Fraternal Cemetery Rd
Belington, WV 26250
Phone (304) 636-2340

1620 Harrison Ave
Elkins, WV 26241
Phone (304) 626-2340

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1558674697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6763",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260030918",
            "telephone_number": "304-242-7106",
            "fax_number": "304-242-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 FAIRMONT AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542135",
            "telephone_number": "304-363-0050",
            "fax_number": "304-363-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOONOVER",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "002850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.