Kevin S Ivory, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

700 Oakmound Rd
Clarksburg, WV 26301-9398

Phone

(304) 623-6330

NPI assigned

Oct 23, 2020

Last updated

Feb 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Care of West Virginia, Inc.Group PAC ID 0446232987, shared by 74 NPIs, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Hospital of Buckhannon, Inc Hospital, Buckhannon, WV, CCN 511321
• United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.ivory.1@4803.direct.athenahealth.com

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.

• Community Care of West Virginia, Inc.

  dba Community Care of Clarksburg

  • Federally Qualified Health Center (FQHC)
  • Clarksburg, WV
  • NPI 1053742668
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Community Care Connections of Buckhannon

  • Federally Qualified Health Center (FQHC)
  • Buckhannon, WV
  • NPI 1063048189
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba CareXpress of Weston

  • Federally Qualified Health Center (FQHC)
  • Weston, WV
  • NPI 1073944658
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba CareXpress of Buckhannon

  • Federally Qualified Health Center (FQHC)
  • Buckhannon, WV
  • NPI 1114277050
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Community Care Connections of Flatwoods

  • Federally Qualified Health Center (FQHC)
  • Sutton, WV
  • NPI 1609042266
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Community Care of Weston II

  • Federally Qualified Health Center (FQHC)
  • Weston, WV
  • NPI 1619464369
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Community Care of Flatwoods

  • Federally Qualified Health Center (FQHC)
  • Sutton, WV
  • NPI 1770917577
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Community Care of Buckhannon

  • Federally Qualified Health Center (FQHC)
  • Buckhannon, WV
  • NPI 1891241030
  Medicare reassignment NPD
• Community Care of West Virginia Inc

  dba CareXpress of Slaty Fork

  • Federally Qualified Health Center (FQHC)
  • Slatyfork, WV
  • NPI 1215741665
  NPD
• Community Care of West Virginia Inc

  dba Adamston Elementary School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Clarksburg, WV
  • NPI 1851787121
  NPD
• Community Care of West Virginia, Inc.

  dba Pocahontas County High School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Dunmore, WV
  • NPI 1043567456
  NPD
• Community Care of West Virginia, Inc.

  dba Little Birch Elementary School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Sutton, WV
  • NPI 1053821363
  NPD

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

• St Josephs Hospital of Buckhannon Inc

  • Critical Access Hospital
  • Buckhannon, WV
  • NPI 1124005061
  Care Compare affiliation
• United Hospital Center, Inc

  • General Acute Care Hospital
  • Bridgeport, WV
  • NPI 1184606600
  Care Compare affiliation

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644624000000",
    "number": "1770182354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OAKMOUND RD",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263019398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OAKMOUND RD",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263019398",
            "telephone_number": "304-623-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVORY",
        "first_name": "KEVIN",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-23",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy J Hutton
• Angela Rose Insani
• Ailsa Iquinto-Jones
• Cris M Irwin, SLP
• Barbara A Ivers
• Leesa Jackson, MA, NCC, LPC
• Sarah Jackson, DPT
• Sidney Boggess Jackson, M.D.
• Martha Ann Jacob
• Jamie Lynn Jacobson

• Physician Assistant in Clarksburg, WV
• Providers in Clarksburg, 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 Feb 12, 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.