Christine Hupp, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004135 Issued in OH

Practice address

400 Matthew St Ste 401
Marietta, OH 45750-1656

Phone

(740) 376-1924

Fax

(740) 376-5551

NPI assigned

Sep 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Christine Widgren Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marietta Memorial HospitalGroup PAC ID 8224928965, 387 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marietta Memorial Hospital Hospital, Marietta, OH, CCN 360147

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 and National Provider Directory roles.

• Marietta Memorial Hospital

  • Rural Health Clinic/Center
  • Woodsfield, OH
  • NPI 1962106328
  Medicare reassignment Care Compare group
• Marietta Memorial Hospital

  • General Acute Care Hospital
  • Marietta, OH
  • NPI 1447649025
  NPD
• Marietta Memorial Hospital

  • General Acute Care Hospital
  • Marietta, OH
  • NPI 1215936927
  NPD (past)

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

• Marietta Memorial Hospital

  • General Acute Care Hospital
  • Marietta, OH
  • NPI 1215936927
  Care Compare affiliation

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1730581125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449",
            "telephone_number": "740-374-4500",
            "fax_number": "740-374-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MATTHEW ST STE 401",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501656",
            "telephone_number": "740-376-1924",
            "fax_number": "740-376-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPP",
        "first_name": "CHRISTINE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110574",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - MHCPI",
            "identifier": "P01482363",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christine.hupp@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "400 Matthew St Ste 401",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "WIDGREN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Frederic A. Humphrey, DO
• Nicole Rae Humphrey, CNP
• Eric C. Hunkele, M.D.
• Karen E Hunsaker, LISW, LICDC
• Alexis Hupp
• Amanda Jane Hurst, RCP
• Adam Husk
• Mona Abdelgalil Imam, M.D.
• Gregory C Ingram, OD
• Dominique Paul Irizarry

• Physician Assistant in Marietta, OH
• Providers in Marietta, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.
• 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.