Jessica Mongold, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

108062 Issued in WV

Practice address

21 Auction LN Ste a
Buckhannon, WV 26201-8968

Phone

(304) 472-6041

NPI assigned

Jan 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 4

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mongold Medical Services LLC

  • Family Nurse Practitioner
  • Buckhannon, WV
  • NPI 1114887825
  Medicare reassignment NPD Authorized official
• Grant Memorial Hospital Inc

  • Critical Access Hospital
  • Petersburg, WV
  • NPI 1013603919
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  WV

  Medicare reassignment NPD
• Grant Memorial Hospital Inc

  • Family Medicine Physician
  • Petersburg, WV
  • NPI 1679269583
  NPD
• St Josephs Hospital of Buckhannon Inc

  • Critical Access Hospital
  • Buckhannon, WV
  • NPI 1124005061
  NPD
• St Josephs Hospital of Buckhannon

  • Internal Medicine Physician
  • Buckhannon, WV
  • NPI 1841314473
  NPD (past)

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1730777970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 AUCTION LN STE A",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262018968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 AUCTION LN STE A",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262018968",
            "telephone_number": "304-472-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGOLD",
        "first_name": "JESSICA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "108062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmongold152640@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmongold152640@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmongold152640@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmongold152640@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Mills
• Christine Allison Mills
• John O Mills, DO
• Sheila Faye Minix
• Mongold Medical Services LLC
• Dawn Montalvo
• April M Moore
• Gregory S. Moore, OD
• Hope S Moore
• Morgan Psychological Services

• Family Nurse Practitioner in Buckhannon, WV
• Providers in Buckhannon, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.