Jennifer Lynn Childers, PHYSICIAN ASSITANT -

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

785 Issued in WV

Practice address

1100 Main St Ste 104
Wheeling, WV 26003-2737

Phone

(304) 460-5123

Fax

(800) 734-8498

NPI assigned

Aug 27, 2008

Last updated

Apr 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, WV2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• GR&W, Inc

  dba GR&W Harmony

  • Clinical Neuropsychologist
  • Morgantown, WV
  • NPI 1407192024
  Medicare reassignment
• Robert J Wetzel, MD

  • Obstetrics & Gynecology Physician
  • Saint Clairsville, OH
  • NPI 1659384907
  Medicare reassignment
• GR&W, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morgantown, WV
  • NPI 1992665723
  NPD

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1689821068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 WHITE WILLOW WAY",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265056119",
            "telephone_number": "304-460-5123",
            "fax_number": "800-734-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MAIN ST STE 104",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260032737",
            "telephone_number": "304-460-5123",
            "fax_number": "800-734-8498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Martins Ferry",
            "state": "OH",
            "postal_code": "439351648",
            "country_code": "US",
            "telephone_number": "740-633-4127",
            "fax_number": "740-633-4185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSITANT -",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2023-04-17",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Chamblin
• Tina Chandler
• Charla L. Anderson, M.D.
• Heather Nicole Chatary
• Asmi Chattaraj, M.D.
• William Asher Childers Jr., PA-C
• Richard Ronald Chiplinski, RPH
• Edward Kin Chiu, M.D.
• Robert Basil Chrest Jr., D.O.
• Christian a. Sonnefeld, MD, PLLC

• Physician Assistant in Wheeling, WV
• Providers in Wheeling, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.