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DEBRA L FOX
NPI 1912520800
Nurse Practitioner - Family in Morgantown, WV

Active since May 26, 2020PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
3420 LAZZELLE UNION RD, MORGANTOWN, WV 26501(304) 685-0398 Get Directions Write a Review

NPPES record last updated: September 15, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 15, 2022, Jul 23, 2021, Jan 12, 2021 and 1 more (4 updates tracked since 2020).

About Debra L Fox NPPES

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

DEBRA L FOX (NPI 1912520800) is an individual family provider in Morgantown, West Virginia, licensed in West Virginia (105691) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, is affiliated with Uniontown Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1912520800
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDEBRA L FOX
Location Address3420 LAZZELLE UNION RDMorgantown, WV 26501-2086
Mailing Address3420 Lazzelle Union RdMorgantown, WV 26501-2086 · (304) 685-0398
Phone(304) 685-0398
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateMay 26, 2020
Last NPPES UpdateSeptember 15, 20224 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2022
✔ NPI 1912520800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in WV · 105691✔ Licensed in PA · SP021993
3420 LAZZELLE UNION RD, Morgantown, WV 26501
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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

Debra L Fox 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 ID6709206782
PECOS Enrollment IDI20201013000806
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.
171 services96 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.
50 services50 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.
31 services29 patients

Hospital Affiliations CMS Care Compare 3

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

Uniontown Hospital

Acute Care Hospitals · Uniontown, PA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390041
Location500 West Berkeley StreetUniontown, PA 15401 · Fayette County
Emergency services

Washington Health System Greene

Acute Care Hospitals · Waynesburg, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number390150
Location350 Bonar AvenueWaynesburg, PA 15370 · Greene County
Emergency services

West Virginia University Hospitals, Inc

Acute Care Hospitals · Morgantown, WV
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510001
Location1 Medical Center DriveMorgantown, WV 26506 · Monongalia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26501 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
Quality78.46
Promoting Interoperability100
Improvement Activities40

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 Debra Fox's NPI number?

The NPI number for Debra Fox is 1912520800. It was assigned to this individual provider in the NPPES registry on May 26, 2020.

Where is Debra Fox located?

Debra Fox practices at 3420 Lazzelle Union Rd, Morgantown, WV 26501. The listed phone number is (304) 685-0398.

What is Debra Fox's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Debra Fox enrolled in Medicare?

Yes. Debra Fox is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Debra Fox accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Debra Fox 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.

Is Debra Fox affiliated with any hospitals?

According to CMS data, Debra Fox is affiliated with Uniontown Hospital, Washington Health System Greene and West Virginia University Hospitals, Inc.

When was this NPI record last updated?

The NPPES record for Debra Fox was last updated on September 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.