Kenneth Earl Gwinn Jr., FNP-C
Individual provider Active NPI Family Nurse Practitioner · Rainelle, WV
NPI 1003417023 · NPPES record last updated Nov 5, 2020
Key facts
- NPI
- 1003417023
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 107635 (WV)
- Practice address
- 176 Medical Center Dr
Rainelle, WV 25962-1064 - Phone
- (304) 438-6188
- NPI assigned
- Nov 5, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rainelle Medical Center Inc
Practice addresses (Care Compare)
128 Community LN
White Sulphur Springs, WV 24986-1105
Phone (304) 956-2577
26737 Midland Trail
Hico, WV 25854
Phone (304) 969-8080
296 Fair St
Lewisburg, WV 24901-2632
Phone 30443861881002
390 Industrial Park Rd
Maxwelton, WV 24957-8073
Phone 30443861881002
458 Greenbrier St
Rupert, WV 25984-1404
Phone (304) 438-6188
595 Spartan LN
Lewisburg, WV 24901-9438
Phone (304) 645-1052
Hospital & facility affiliations
- Adoration Home Health
- Home Care Plus, Incorporated
- Camc Greenbrier Valley Medical Center, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210323000065 | WV | Practitioner - Nurse Practitioner | 5395152169 | Reassigns benefits to 9 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107635 | WV | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rainelle Medical Center, Inc | Current |
Accepting new patients | |
| Rainelle Medical Center, Inc | Current | Accepting new patients | |
| Rainelle Medical Center, Inc. | Current |
Accepting new patients | |
| Rainelle Medical Center, Inc | Current |
Accepting new patients | |
| Rainelle Medical Center, Inc | Current | Accepting new patients | |
| Rainelle Medical Center, Inc | Current | Accepting new patients | |
| Rainelle Medical Center Inc | Current |
Accepting new patients | |
| Rainelle Medical Center Inc | Current |
Accepting new patients | |
| Rainelle Medical Center, Inc. | Current |
Accepting new patients | |
| Rainelle Medical Center Inc | Current |
Accepting new patients | |
| Rainelle Medical Center, Inc. | Current |
Accepting new patients | |
| Rainelle Medical Center, Inc. | Current |
Accepting new patients | |
| Rainelle Medical Center, Inc. | Current |
Accepting new patients | |
| Rainelle Medical Center Inc | Current | Accepting new patients | |
| Camden on Gauley Medical Center Inc | Past | Accepting new patients | |
| Rainelle Medical Center, Inc. | Past | Accepting new patients |
Locations
101 Railroad St
Alderson, WV 24910
Phone (304) 438-6818
2140 Jefferson St N
Ste 200
Lewisburg, WV 24901
Phone (681) 484-7042
296 Fair St
Lewisburg, WV 24901
Phone (304) 647-4747
595 Spartan Ln
Lewisburg, WV 24901
Phone (304) 645-1052
390 Industrial Park Rd
Maxwelton, WV 24957
Phone (681) 318-3610
176 Medical Center Dr
Rainelle, WV 25962
205 Medical Center Dr
Rainelle, WV 25962
Phone (304) 438-1922
458 Greenbrier St
Rupert, WV 25984
Phone (304) 632-6602
128 Community Ln
White Sulphur Springs, WV 24986
Phone (304) 536-2454
Interoperability endpoints
- kennethgwinn@rmc.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 107635 | WV | Yes |
Addresses
Primary practice location
176 Medical Center Dr
Rainelle, WV 25962-1064
Mailing address
176 Medical Center Dr
Rainelle, WV 25962-1064
Phone (304) 438-6188
Other providers in Rainelle, WV
- God'S Way Home, Inc.
- Brenda Goins
- Trista T Graham
- Greenbrier Valley Physical Therapy, LLC
- Audra Gregg
- Donna Rosetta Hamrick
- Abrienda Alexandria Hanna
- Alyssa Ann Hanna
- Lindsey Marie Hanna
- Tammy Jean Hanna
All providers in Rainelle, WV · Family Nurse Practitioner in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.