Individual provider Active NPI

Jeremy Ryan Stapleton, DO

  • Gastroenterology Physician
  • Charleston, WV
National Provider Identifier
1609905462
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2126 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
Mar 5, 2007
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2126 WV Primary
Internal Medicine Physician 207R00000X 03019 KY
Hospitalist Physician 208M00000X 03019 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

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

Other practice location 2

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

Other practice location 3

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

Other practice location 4

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

Other identifiers 9

IdentifierTypeStateIssuer
107365OtherKYSIHO - NIS
7100080660MedicaidKY
000000628054OtherKYANTHEM - NIS
000028412UOtherKYHUMANA - NIS
2546966OtherKYCIGNA - NIS
3810019300MedicaidWV
3733152000OtherKYPASSPORT ADVANTAGE - NIS
50025382OtherKYPASSPORT - NIS
200963400MedicaidIN

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
I20100928001682 WV Practitioner - Gastroenterology 6103963749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
West Virginia School of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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

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
25.85 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
86.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy331
Upper gastrointestinal (GI) endoscopy for acid reflux263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2126WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Dec 30, 2015 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Dec 30, 2015 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

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

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

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

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

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

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

3703 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 757-2273

Organizations & group practices 3

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1609905462",
    "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": "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"
        },
        {
            "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": "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": "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"
        }
    ],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "JEREMY",
        "middle_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WV",
            "license": "2126",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "03019",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "03019",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO - NIS",
            "identifier": "107365",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100080660",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - NIS",
            "identifier": "000000628054",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA - NIS",
            "identifier": "000028412U",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA - NIS",
            "identifier": "2546966",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810019300",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE - NIS",
            "identifier": "3733152000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT - NIS",
            "identifier": "50025382",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200963400",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.