MOUNTAIN STATE MEDICAL SPECIALTIES, PLLC
NPI 1891892097
Dermatology in Bridgeport, WV

Q: What is Mountain State Medical Specialties, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since September 20, 2006

120 MEDICAL PARK DR, SUITE 200, BRIDGEPORT, WV 26330(304) 624-7200(304) 554-0413 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 14, 2025, Jul 18, 2019 (2 updates tracked since 2019).

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About Mountain State Medical Specialties, Pllc NPPES

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

MOUNTAIN STATE MEDICAL SPECIALTIES, PLLC (NPI 1891892097) is a healthcare organization registered as a dermatology in Bridgeport, West Virginia and active in the NPI registry since September 2006. The organization lists Eugene Brent Kirkland, Cmo, as its authorized official.

NPPES Registry Identity

NPI1891892097

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameMOUNTAIN STATE MEDICAL SPECIALTIES, PLLC

Location Address120 MEDICAL PARK DR, SUITE 200Bridgeport, WV 26330-9012

Mailing AddressPo Box 746750Atlanta, GA 30374-6750 · (866) 680-8505 · Fax (937) 436-4156

Phone(304) 624-7200

Fax(304) 554-0413

Organization SubpartNo

Authorized OfficialEugene Brent KirklandCmo · (513) 701-5526

Enumeration DateSeptember 20, 2006

Last NPPES UpdateMarch 14, 20252 updates tracked since enumeration

NPPES CertifiedMarch 14, 2025

✔ NPI 1891892097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedAllergy & ImmunologyTaxonomy 207K00000X

Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X

Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X

Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · RheumatologyTaxonomy 207RR0500X

120 MEDICAL PARK DR, Bridgeport, WV 26330

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Other Identifiers 1

Medicaid3810004579WV

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mountain State Medical Specialties, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 24 clinicians reassign Medicare billing to Mountain State Medical Specialties, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 6 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 6

Dermatology15

Nurse Practitioner3

Family Practice2

Micrographic Dermatologic Surgery (MDS)2

Allergy/Immunology1

Pathology1

Nearest to this location (20)

See all 24

Heaven Mcgee, APRN

Nurse Practitioner

NPI 1104589480

120 MEDICAL PARK DR STE 200
Bridgeport, WV 26330

(304) 624-7200

✔ PECOS✔ Accepts MedicareSame address

Jeffrey Dodson, M.D.

Dermatology

NPI 1649212903

120 MEDICAL PARK DR SUITE 200
Bridgeport, WV 26330

(304) 624-7200

✔ PECOS✔ Accepts Medicare0.2 mi

Sharifeh Farasat, MD

Dermatology

NPI 1053553131

120 MEDICAL PARK DR SUITE 300
Bridgeport, WV 26330

(304) 624-7200

✔ PECOS✔ Accepts Medicare0.2 mi

Charles Franz, M.D.

Dermatology

NPI 1215973995

120 MEDICAL PARK DR SUITE 200
Bridgeport, WV 26330

(304) 624-7200

✔ PECOS✔ Accepts Medicare0.2 mi

Dominick Woofter, M.D.

Family Practice

NPI 1760581326

1664 E PIKE STREET
Clarksburg, WV 26301

(304) 709-7000

✔ PECOS✔ Accepts Medicare5.0 mi

Isha Woofter, M.D.

Family Practice

NPI 1679672232

1664 E PIKE STREET
Clarksburg, WV 26301

(304) 709-7000

✔ PECOS✔ Accepts Medicare5.0 mi

David Carlisle, M.D.

Micrographic Dermatologic Surgery (MDS)

NPI 1639231087

165 SCOTT AVE SUITE 100
Morgantown, WV 26508

(304) 554-0400

✔ PECOS✔ Accepts Medicare23 mi

Lakimerly Coates, MD

Dermatology

NPI 1871576264

165 SCOTT AVE STE 100
Morgantown, WV 26508

(715) 531-5650

✔ PECOS✔ Accepts Medicare23 mi

John Hancox, M.D.

Micrographic Dermatologic Surgery (MDS)

NPI 1104804632

165 SCOTT AVE SUITE 100
Morgantown, WV 26508

(304) 554-0400

✔ PECOS✔ Accepts Medicare23 mi

Amy Norton, M.D.

Dermatology

NPI 1336192624

165 SCOTT AVE SUITE 100
Morgantown, WV 26508

(304) 554-0400

✔ PECOS✔ Accepts Medicare23 mi

Jeffrey Jackson, M.D.

Dermatology

NPI 1780611590

100 SENECA RD
Elkins, WV 26241

(304) 637-2777

✔ PECOS✔ Accepts Medicare36 mi

Paul Ogershok, MD

Allergy/Immunology

NPI 1568471480

1150 7TH ST
Waynesburg, PA 15370

(724) 627-2395

✔ PECOS✔ Accepts Medicare39 mi

Justin Lee, MD

Dermatology

NPI 1679159776

500 CABELA DR
Triadelphia, WV 26059

(681) 618-1011

✔ PECOS✔ Accepts Medicare53 mi

Brooke Bertus, MD

Dermatology

NPI 1497382436

800 GRAND CENTRAL MALL STE 3
Vienna, WV 26105

(304) 865-0555

✔ PECOS✔ Accepts Medicare70 mi

Janelle King, M.D.

Dermatology

NPI 1386879138

800 GRAND CENTRAL MALL SUITE 3
Vienna, WV 26105

(304) 865-0555

✔ PECOS✔ Accepts Medicare70 mi

Barrett Louden, MD

Dermatology

NPI 1972786952

800 GRAND CENTRAL MALL SUITE 3
Vienna, WV 26105

(304) 865-0555

✔ PECOS✔ Accepts Medicare70 mi

Michelle Endicott, DO

Dermatology

NPI 1699774315

4815 KANAWHA AVE SW
South Charleston, WV 25309

(304) 768-4567

✔ PECOS✔ Accepts Medicare105 mi

Todd Kreitzer, D.O.

Dermatology

NPI 1841406766

4815 KANAWHA AVE SW
South Charleston, WV 25309

(304) 768-4567

✔ PECOS✔ Accepts Medicare105 mi

Megan Clatworthy, FNP

Nurse Practitioner

NPI 1982465373

422 KINETIC PARK DRIVE SUITE B
Huntington, WV 25701

(304) 523-5100

✔ PECOS✔ Accepts Medicare134 mi

Adrienne Jordan, M.D

Pathology

NPI 1982845921

7835 PARAGON RD
Dayton, OH 45459

(800) 532-3232

✔ PECOS✔ Accepts Medicare212 mi

See all 24 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Mountain State Medical Specialties, PLLC's NPI number?

The NPI number for Mountain State Medical Specialties, PLLC is 1891892097. It was assigned to this organization in the NPPES registry on September 20, 2006.

Where is Mountain State Medical Specialties, PLLC located?

Mountain State Medical Specialties, PLLC is located at 120 Medical Park Dr Suite 200, Bridgeport, WV 26330. The listed phone number is (304) 624-7200.

What is Mountain State Medical Specialties, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Mountain State Medical Specialties, PLLC enrolled in Medicare?

Yes. Mountain State Medical Specialties, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mountain State Medical Specialties, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 24 clinicians in 6 Medicare specialties reassign their Medicare billing to Mountain State Medical Specialties, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (15), Nurse Practitioner (3) and Family Practice (2). Of these, 1 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mountain State Medical Specialties, PLLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield and 2 other insurers list Mountain State Medical Specialties, PLLC 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 Mountain State Medical Specialties, PLLC was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.