Individual provider Active NPI

Jennifer Moran

  • Family Nurse Practitioner
  • Martinsburg, WV
National Provider Identifier
1689206716
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
105400 Issued in WV
Practice address
120 Campus Dr
Suite 100
Martinsburg, WV 25404
Phone
(681) 247-1250
NPI assigned
Feb 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024178665 VA
Family Nurse Practitioner 363LF0000X 105400 WV Primary

Addresses

Primary practice location

120 Campus Dr
Suite 100
Martinsburg, WV 25404

Mailing address

220 Campus Blvd Ste 100
Winchester, VA 22601-2888

Other practice location 1

607 E Jubal Early Dr
Winchester, VA 22601-5178
Phone (540) 536-2232

Other practice location 2

65 Riverton Commons Dr
Front Royal, VA 22630-6768
Phone (540) 635-0700

Other practice location 3

160 Merchant St Ste 200
Winchester, VA 22603-4772
Phone (540) 536-5950

Other practice location 4

33820 Old Valley Pike Ste 2
Strasburg, VA 22657-3793
Phone (540) 459-1310

Other practice location 5

97 Administrative Dr
Martinsburg, WV 25404-6378
Phone (304) 350-3200

Other practice location 6

415A South St
Front Royal, VA 22630-2115
Phone (540) 636-0495

Other practice location 7

100 Oak Lee Dr
Ranson, WV 25438-4879
Phone (304) 930-0001

Other practice location 8

97 Administrative Dr # 200
Martinsburg, WV 25404-6378
Phone (304) 350-3230

Other practice location 9

101 Marcley Dr
Martinsburg, WV 25401-2977
Phone (304) 263-8911

Other practice location 10

1000 Tavern Rd Ste 100
Martinsburg, WV 25401-2853
Phone (681) 247-1080

Electronic endpoints 11

TypeEndpointUseAffiliation
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org
Direct Messaging Address jmoran129206@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 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
I20200416002728 WV Practitioner - Nurse Practitioner 8325478233 Reassigns benefits to 1 organization
I20200519001622 VA Practitioner - Nurse Practitioner 8325478233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Regional Enterprises, IncGroup PAC ID 0446164495, 53 clinicians

Practice addresses (Care Compare)

100 Oak Lee Dr
Ranson, WV 25438-4879
Phone (304) 930-0001

607 E Jubal Early Dr
Winchester, VA 22601-5178
Phone (540) 536-2232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024178665VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince May 27, 2023 Accepting new patients
East Mountain Health Physicians Inc. CurrentSince Feb 9, 2020 Accepting new patients
Valley Regional Enterprises, Inc CurrentSince Apr 15, 2020 Accepting new patients
Valley Regional Enterprises, Inc CurrentSince Apr 15, 2020 Accepting new patients
East Mountain Health Physicians, Inc. CurrentSince Mar 11, 2020 Accepting new patients
Privia Medical Group, LLC CurrentSince May 27, 2023 Accepting new patients
East Mountain Health Physicians, Inc. CurrentSince Mar 11, 2020 Accepting new patients
East Mountain Health Physicians, Inc. PastSince Feb 9, 2020 Accepting new patients
Warren Memorial Hospital, Inc. Past Accepting new patients
East Mountain Health Physicians, Inc. Past Accepting new patients

Locations

415A South St
Front Royal, VA 22630
Phone (540) 636-0495

65 Riverton Commons Dr
Front Royal, VA 22630
Phone (540) 635-0700

8644 Sudley Rd
#220
Manassas, VA 20110

33820 Old Valley Pike
Ste 2
Strasburg, VA 22657
Phone (540) 459-1310

220 Campus Blvd
Ste 100
Winchester, VA 22601

607 E Jubal Early Dr
Winchester, VA 22601
Phone (540) 536-2232

160 Merchant St
#200
Winchester, VA 22603
Phone (540) 536-5950

120 Campus Dr
Ste 221
Martinsburg, WV 25404
Phone (681) 247-1280

101 Marcley Dr
Martinsburg, WV 25401
Phone (304) 263-8911

1000 Tavern Rd
Ste 100
Martinsburg, WV 25401
Phone (304) 267-9355

1004 Sushruta Dr
Ste D
Martinsburg, WV 25401
Phone (304) 262-2538

97 Administrative Dr
#200
Martinsburg, WV 25404
Phone (304) 350-3230

120 Campus Dr
Ste 100
Martinsburg, WV 25404
Phone (681) 247-1250

97 Administrative Dr
Martinsburg, WV 25404
Phone (304) 350-3200

120 Campus Dr
Ste 101
Martinsburg, WV 25404
Phone (681) 247-1250

100 Oak Lee Dr
Ranson, WV 25438
Phone (304) 350-0001

Interoperability endpoints

  • Direct secure messaging: jmoran129206@soc.inova.org
  • Direct secure messaging: jmoran129206@valleyhealth.direct-ci.com

Organizations & group practices 10

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": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1689206716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CAMPUS DR",
            "address_2": "SUITE 100",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25404",
            "telephone_number": "681-247-1250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "607 E Jubal Early Dr",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226015178",
            "country_code": "US",
            "telephone_number": "540-536-2232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "65 Riverton Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Front Royal",
            "state": "VA",
            "postal_code": "226306768",
            "country_code": "US",
            "telephone_number": "540-635-0700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Merchant St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226034772",
            "country_code": "US",
            "telephone_number": "540-536-5950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33820 Old Valley Pike Ste 2",
            "address_purpose": "LOCATION",
            "city": "Strasburg",
            "state": "VA",
            "postal_code": "226573793",
            "country_code": "US",
            "telephone_number": "540-459-1310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "97 Administrative Dr",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254046378",
            "country_code": "US",
            "telephone_number": "304-350-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415A South St",
            "address_purpose": "LOCATION",
            "city": "Front Royal",
            "state": "VA",
            "postal_code": "226302115",
            "country_code": "US",
            "telephone_number": "540-636-0495",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Oak Lee Dr",
            "address_purpose": "LOCATION",
            "city": "Ranson",
            "state": "WV",
            "postal_code": "254384879",
            "country_code": "US",
            "telephone_number": "304-930-0001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "97 Administrative Dr # 200",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254046378",
            "country_code": "US",
            "telephone_number": "304-350-3230",
            "fax_number": "304-350-3244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Marcley Dr",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254012977",
            "country_code": "US",
            "telephone_number": "304-263-8911",
            "fax_number": "304-263-9450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Tavern Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254012853",
            "country_code": "US",
            "telephone_number": "681-247-1080",
            "fax_number": "681-247-1081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178665",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "105400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "65 Riverton Commons Dr",
            "city": "Front Royal",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226306768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "160 Merchant St Ste 200",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226034772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "607 E Jubal Early Dr",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226015178",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "415A South St",
            "city": "Front Royal",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226302115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "100 Oak Lee Dr",
            "city": "Ranson",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254384879",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "120 Campus dr",
            "address_2": "Suite 100",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "25404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "97 Administrative Dr",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254046378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "33820 Old Valley Pike Ste 2",
            "city": "Strasburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226573793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "1000 Tavern Rd Ste 100",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254012853",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "97 Administrative Dr # 200",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254046378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoran129206@soc.inova.org",
            "affiliation": "N",
            "address_1": "101 Marcley Dr",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254012977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.