Individual provider Active NPI

Jenna Lee Barraclough, PA-C

  • Physician Assistant
  • Martinsburg, WV
National Provider Identifier
1649812090
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1013 Issued in WV
Practice address
1008 Tavern Rd Ste 102
Martinsburg, WV 25401-2801
Phone
(304) 263-5129
Fax
(304) 263-3726
NPI assigned
Oct 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 57130 CA
Physician Assistant 363A00000X 1013 WV Primary
Physician Assistant 363A00000X C0009982 MD

Addresses

Primary practice location

1008 Tavern Rd Ste 102
Martinsburg, WV 25401-2801

Mailing address

220 Campus Blvd Ste 320
Winchester, VA 22601-2889
Phone (540) 536-5100

Other practice location 1

4300 Golden Center Dr Ste C
Placerville, CA 95667-6278
Phone (530) 344-2070

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbarraclough1512294@ValleyHealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191217002667 CA Practitioner - Physician Assistant 0042644437 Reassigns benefits to 1 organization
I20250925002785 MD Practitioner - Physician Assistant 0042644437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1004 Fowler Way
Placerville, CA 95667-5746
Phone (530) 626-9488

1095 Marshall Way
Placerville, CA 95667-5722

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

13 Western Maryland Pkwy
202 Wellspan Rehabilitation Services
Hagerstown, MD 21740-6474
Phone (301) 797-9240

17 Western Maryland Pkwy
Hagerstown, MD 21740-5471
Phone (301) 797-9240

3501 Palmer Dr
Cameron Park, CA 95682-8276

4201 Town Ctr Blvd
El Dorado Hills, CA 95762-7100
Phone (916) 905-6378

4300 Golden Ctr Dr
Placerville, CA 95667-6278

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57130CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center Single Specialty CurrentSince Dec 1, 2019 Accepting new patients
Wellspan Medical Group CurrentSince Oct 20, 2025 Accepting new patients
Wellspan Medical Group Single Specialty CurrentSince Oct 20, 2025 Accepting new patients
Marshall Medical Center Single Specialty CurrentSince Dec 1, 2019 Accepting new patients
Wellspan Medical Group Physician Assistant Past Accepting new patients
Marshall Medical Center Past Accepting new patients

Locations

3501 Palmer Dr
Ste 201
Cameron Park, CA 95682
Phone (530) 626-2611

4300 Golden Center Dr
Ste C
Placerville, CA 95667
Phone (530) 344-2070

1004 Fowler Way
Ste 4
Placerville, CA 95667
Phone (530) 626-9488

17 Western Maryland Pkwy
Ste 100
Hagerstown, MD 21740
Phone (301) 797-6389

52 Water St
Thurmont, MD 21788
Phone (301) 271-3535

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: jbarraclough499619@wellspan.direct-ci.com

Organizations & group practices 7

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 5

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": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1649812090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 320",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012889",
            "telephone_number": "540-536-5100",
            "fax_number": "540-536-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 TAVERN RD STE 102",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012801",
            "telephone_number": "304-263-5129",
            "fax_number": "304-263-3726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Golden Center Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Placerville",
            "state": "CA",
            "postal_code": "956676278",
            "country_code": "US",
            "telephone_number": "530-344-2070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRACLOUGH",
        "first_name": "JENNA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57130",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1013",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009982",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbarraclough1512294@ValleyHealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1008 Tavern Rd Ste 102",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254012801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.