GRETCHEN DAWN EGBERT SPROUSE MD
NPI 1497048904
Family Medicine in Ranson, WV

Q: What is Gretchen Sprouse's NPI number?

The NPI number for Gretchen Sprouse is 1497048904. It was assigned to this individual provider in the NPPES registry on May 17, 2011. The provider is also known as Gretchen Dawn Egbert.

Q: What is Gretchen Sprouse's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Gretchen Sprouse was last updated on April 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 17, 2011PECOS EnrolledAccepts Medicare Assignment

94.1/100

CMS Quality Rating

203 E 4TH AVE, UHP WOMEN'S HEALTH & FAMILY MEDICINE, RANSON, WV 25438(304) 725-6343(304) 725-5523 Get Directions Write a Review

NPPES record last updated: April 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 21, 2022, Jan 12, 2021, Oct 20, 2020 (3 updates tracked since 2020).

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About Gretchen Dawn Egbert Sprouse Md NPPES

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

GRETCHEN DAWN EGBERT SPROUSE MD (NPI 1497048904) is an individual family medicine provider in Ranson, West Virginia, licensed in West Virginia (26397) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS, is affiliated with Berkeley Medical Center, and is a graduate of West Virginia University School Of Medicine (2011).

NPPES Registry Identity

NPI1497048904

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameGRETCHEN DAWN EGBERT SPROUSECredential: MD

Location Address203 E 4TH AVE, UHP WOMEN'S HEALTH & FAMILY MEDICINERanson, WV 25438-1617

Mailing Address203 E 4th Ave, Uhp Women's Health & Family MedicineRanson, WV 25438-1617

Phone(304) 725-6343

Fax(304) 725-5523

Sole ProprietorNo

Medical School CMSWest Virginia University School Of MedicineGraduated 2011

Enumeration DateMay 17, 2011

Last NPPES UpdateApril 21, 20223 updates tracked since enumeration

NPPES CertifiedApril 21, 2022

✔ NPI 1497048904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WV · 26397

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

203 E 4TH AVE, Ranson, WV 25438

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Other Names 1

Former Name (1)Gretchen Dawn Egbert

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gretchen Dawn Egbert Sprouse Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577781608

PECOS Enrollment IDI20140902001316, I20151023002428

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

143 services82 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

55 services55 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

33 services29 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510008

Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County

Emergency services Birthing friendly

Jefferson Medical Center

Critical Access Hospitals · Ranson, WV

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number511319

Location300 South Preston StreetRanson, WV 25438 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25438 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.49 typical visit price

range $53.20 – $164.59

Typical copayment $20.87 (range $13.30 – $41.14)

Most-billed visit code 99203

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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

Quality

78.46

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers11 claims38 services$6.26 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

2 suppliers13 claims32 services$2.88 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier11 claims11 services$5.18 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

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