Individual provider Active NPI

Kristen Whitmore

  • Psychologist
  • Martinsburg, WV
National Provider Identifier
1780115725
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1229 Issued in WV
Practice address
2004 Professional CT
Martinsburg, WV 25401-8808
Phone
(304) 596-5780
Fax
(304) 596-5781
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 1229 WV Primary

Addresses

Primary practice location

2004 Professional CT
Martinsburg, WV 25401-8808

Mailing address

2004 Professional CT
Martinsburg, WV 25401-8808
Phone (304) 596-5780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200819002551 WV Practitioner - Clinical Psychologist 1658797709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1229WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2023 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2023 Accepting new patients
University Healthcare Physicians, Inc. CurrentSince Aug 1, 2020 Accepting new patients
University Healthcare Physicians Inc CurrentSince Aug 1, 2020 Accepting new patients

Locations

2004 Professional Ct
Martinsburg, WV 25401
Phone (304) 263-8964

61 Campus Dr
Ste 200
Martinsburg, WV 25404
Phone (304) 274-6343

2500 Foundation Way
Martinsburg, WV 25401
Phone (304) 264-9202

2000 Foundation Way
Ste 3100
Martinsburg, WV 25401
Phone (304) 260-1436

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 4

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1780115725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 PROFESSIONAL CT",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018808",
            "telephone_number": "304-596-5780",
            "fax_number": "304-596-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 PROFESSIONAL CT",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018808",
            "telephone_number": "304-596-5780",
            "fax_number": "304-596-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMORE",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "1229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.