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STACEY JO KETTLEWELL PA-C
NPI 1164806956
Physician Assistant - Surgical in Wheeling, WV

Active since July 12, 2015PECOS Enrolled
94.1/100
CMS Quality Rating
1 MEDICAL PARK, WHEELING, WV 26003(304) 243-3000(304) 243-3060 Get Directions Write a Review

NPPES record last updated: October 18, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 18, 2019, Oct 23, 2018 (2 updates tracked since 2018).

About Stacey Jo Kettlewell Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACEY JO KETTLEWELL PA-C (NPI 1164806956) is an individual surgical provider in Wheeling, West Virginia, licensed in West Virginia (1904) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164806956
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameSTACEY JO KETTLEWELLCredential: PA-C
Location Address1 MEDICAL PARKWheeling, WV 26003-6379
Mailing Address1 Medical ParkWheeling, WV 26003-6379 · (304) 243-3000 · Fax (304) 243-3060
Phone(304) 243-3000
Fax(304) 243-3060
Sole ProprietorNo
Enumeration DateJuly 12, 2015
Last NPPES UpdateOctober 18, 20192 updates tracked since enumeration
✔ NPI 1164806956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in WV · 1904
1 MEDICAL PARK, Wheeling, WV 26003
Open in Google Maps ↗

Other Names 1

Former Name (1)Stacey Jo Kettlewell Pa-c

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacey Jo Kettlewell Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOLLY E. FISHER SLP
Speech-Language Pathologist
1 MEDICAL PARK
WHEELING, WV 26003
Ohio County (304) 243-3000
KRISTINA JOHNSON PH.D.
Behavior Analyst
1 MEDICAL PARK
WHEELING, WV 26003
Ohio County (304) 243-1134
MICHAEL GARMAN ATC,PTA
Specialist/Technologist (Athletic Trainer)
1 MEDICAL PARK
WHEELING, WV 26003
Ohio County (304) 243-3000
CATHERINE F SANSONE PT
Physical Therapist
1 MEDICAL PARK, WHEELING HOSPITAL INC
WHEELING, WV 26003
Ohio County (304) 243-3124
BILLIE J JOHNSTON PT
Physical Therapist
1 MEDICAL PARK, WHEELING HOSPITAL INC
WHEELING, WV 26003
Ohio County (304) 243-3124
ANGELA HENNIS
Nurse Practitioner (Family)
1 MEDICAL PARK
WHEELING, WV 26003
Ohio County (304) 243-3000
MADELINE F SHIPE CRNA
Nurse Anesthetist, Certified Registered
1 MEDICAL PARK
WHEELING, WV 26003
Ohio County (304) 243-3343
TERRY L STAKE M.D.
Radiology (Diagnostic Radiology)
1 MEDICAL PARK
WHEELING, WV 26003
Ohio County (304) 243-3270

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacey Kettlewell's NPI number?

The NPI number for Stacey Kettlewell is 1164806956. It was assigned to this individual provider in the NPPES registry on July 12, 2015. The provider is also known as Stacey Jo Kettlewell Pa-C.

Where is Stacey Kettlewell located?

Stacey Kettlewell practices at 1 Medical Park, Wheeling, WV 26003. The listed phone number is (304) 243-3000.

What is Stacey Kettlewell's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Stacey Kettlewell enrolled in Medicare?

Yes. Stacey Kettlewell is registered in the Medicare PECOS enrollment system.

What insurance does Stacey Kettlewell accept?

Health plans from CareSource list Stacey Kettlewell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stacey Kettlewell was last updated on October 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.