Jenniffer Ridgeway, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

110019 Issued in WV

Practice address

17548 Veterans Memorial Hwy
Kingwood, WV 26537-9797

Phone

(304) 441-2001

NPI assigned

Jun 7, 2011

Reactivated

Jul 15, 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

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

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.

• Preston Health Care Services LLC

  • Family Health Clinical Nurse Specialist
  • Kingwood, WV
  • NPI 1811220643
  NPD

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1780978783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242",
            "city": "NEWBURG",
            "state": "WV",
            "postal_code": "264100242",
            "telephone_number": "304-940-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17548 VETERANS MEMORIAL HWY",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265379797",
            "telephone_number": "304-441-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGEWAY",
        "first_name": "JENNIFFER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "deactivation_date": "2021-06-30",
        "reactivation_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "110019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edith Reveles
• Teresa Marie Reynolds, PT, MBA
• Holly Danelle Rhodes
• Jamie Richardson, CRNA
• Shyla Sharee Ridenour
• Heather Robba
• Elise Roman, OT
• Emily Rossi, PHARM.D.
• Debbie Rouzee
• Karolyn Ruggles

• Family Nurse Practitioner in Kingwood, WV
• Providers in Kingwood, 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 Jul 19, 2021; 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.