MRS. KAREN L SPOTLOE PA-C
NPI 1912942764
Physician Assistant in Belington, WV
NPI Status: Active since June 17, 2006
Contact Information
70 N STURMER ST
BELINGTON, WV
ZIP 26250
Phone: (304) 823-2800
Fax: (304) 823-2703
- Individual
- Female
- Physician Assistant
- Accepts Insurance
- PECOS Enrolled
About KAREN SPOTLOE
This page provides the complete NPI Profile along with additional information for Karen Spotloe, a primary care provider established in Belington, West Virginia with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1912942764 assigned on June 2006. The practitioner's primary taxonomy code is 363A00000X with license number 331 (WV). The provider is registered as an individual and her NPI record was last updated 10 years ago.
- NPI
- 1912942764
- Provider Name
- MRS. KAREN L SPOTLOE PA-C
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 70 N STURMER ST BELINGTON, WV 26250
- Location Phone
- (304) 823-2800
- Location Fax
- (304) 823-2703
- Mailing Address
- 70 N STURMER ST BELINGTON, WV 26250
- Mailing Phone
- (304) 823-2800
- Mailing Fax
- (304) 823-2703
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-17-2006
- Last Update Date
- 10-22-2015
- Code Navigator
A primary care provider (PCP) like Karen Spotloe sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 331
- License State
- WV
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Low Deductible Silver 4500 $3 Generic Drugs - HMO
- Low Deductible Silver 4500 $3 Generic Drugs Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Platinum Zero $5 Generic Drugs - HMO
- Platinum Zero $5 Generic Drugs Adult Vision & Fitness - HMO
- Silver 5000 $20 Generic Drugs - HMO
- Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2028172 | OTHER (01) | WV | MEDICARE PTAN |
| 3810000780 | MEDICAID (05) | WV |
Medicare Participation & PECOS Enrollment Status
Karen Spotloe is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
9 DME suppliers used 41 Medicare Claims 94 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
7 DME suppliers used 26 Medicare Claims 34 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 36 Medicare Claims 36 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 39 Medicare Claims 39 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
3 DME suppliers used 16 Medicare Claims 16 Services Paid
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 26250 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.49
- Minimum New Patient Price $53.2
- Maximum New Patient Price $164.59
- Average New Patient Copayment $20.87
- Minimum New Patient Copayment $13.3
- Maximum New Patient Copayment $41.14
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.84
- Minimum Established Patient Price $16.47
- Maximum Established Patient Price $133.29
- Average Established Patient Copayment $16.71
- Minimum Established Patient Copayment $4.11
- Maximum Established Patient Copayment $33.32
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 1 | 2 | 9 | 4 | 2 | 7 | 6 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 2 | 2 | 18 | 4 | 4 | 7 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 2 + 2 + 1 + 8 + 4 + 4 + 7 + 1 + 2 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1912942764 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1437133451 | PATRICIA A HACKNEY CNM Individual | Advanced Practice Midwife | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1477598225 | MR. GEORGE THOMAS HARWARD PA-C Individual | Physician Assistant | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1619905940 | MR. JOHN P HENDERSON II MD Individual | Family Medicine | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1144483983 | HANNAH ARIEL VALENTINE MD Individual | Family Medicine | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1891245965 | LESA JORDAN RN Individual | Registered Nurse | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1588917371 | LORETTA J WILSON CFNP Individual | Nurse Practitioner (Family) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1720562747 | JAMIE L WILSON LPC Individual | Counselor (Professional) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1922582931 | KIMBERLY W JEFFRIES RN Individual | Registered Nurse | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1841798451 | LINH HOANG PHAM LGSW Individual | Social Worker | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1699089169 | MARK ALLEN HARRIS PA-C Individual | Physician Assistant | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2801 |
| 1174550958 | MRS. CRYSTAL L GREGORY PA-C Individual | Physician Assistant (Medical) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1619991163 | JENNIFER MARIE DUVALL PA-C Individual | Physician Assistant | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1013236793 | RHONDA ANN PARKER NP Individual | Nurse Practitioner (Family) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1053347328 | BELINGTON COMMUNITY MEDICAL SERVICES ASSOCIATION Organization | Clinic/Center (Federally Qualified Health Center (FQHC)) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1154072106 | RACHEL LYNN WILLIAMS MS Individual | Nutritionist (Nutrition, Education) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1407582216 | ALAYNA GRUSS M.A., NCC Individual | Counselor (Professional) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1497480172 | MS. NICHOLE SUSAN FRIDLEY MS Individual | Counselor (Mental Health) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1295318517 | CASEY JO COTTRILL PSYD Individual | Psychologist (Clinical) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1477210052 | BERNARDA BANDAK Individual | Social Worker (Clinical) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
| 1790443000 | MRS. MORGAN TAYLOR NESLAND PA-C Individual | Physician Assistant (Medical) | 70 N STURMER ST BELINGTON, WV 26250 (304) 823-2800 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912942764, enumerated in the NPI registry as an "individual" on June 17, 2006
The provider is located at 70 N Sturmer St Belington, Wv 26250 and the phone number is (304) 823-2800
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider might be accepting Accepts: CareSource, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $83.49 with an average copayment of $20.87 for new patient appointments. Established patients should expect a typical charge of $66.84 and an average copayment of 16.71. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on June 17, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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