Basic Information
| Provider Information | |||||||||
| NPI: | 1144300773 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOOST | ||||||||
| FirstName: | JENNIE | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 MEDICAL CENTER DR | ||||||||
| Address2: | SUITE 4500 | ||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257013656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046911400 | ||||||||
| FaxNumber: | 3046911453 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 MEDICAL CENTER DR STE 4500 | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257013655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046911400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 12/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 43253 | KY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 207V00000X | 25105 | WV | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 50028892 | 01 | KY | PASSPORT PCP & PAD # FOR FOUNDATION LOCATION | OTHER | 50028893 | 01 | KY | PASSPORT SPECIALIST & PASSPORT ADVANTAGE#-FOUNDATION LOCATION | OTHER | 7100118390 | 05 | KY | MEDICAID | K027670 | 01 | KY | MEDICARE PTAN # - KCPAG | OTHER | 50028894 | 01 | KY | PASSPORT SPECIALIST & PAD - PSC LOCATION | OTHER | 50034507 | 01 | KY | PASSPORT & PP ADVTG - WS | OTHER |