Individual provider Active NPI

Janice K Kaufman, FNP-C

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1013982495
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29072 Issued in WV
Practice address
3100 Maccorkle Ave
Suite 709
Charleston, WV 25304-1223
Phone
(304) 342-1184
Fax
(304) 343-8487
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 29072 WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave
Suite 709
Charleston, WV 25304-1223

Mailing address

Camc Outpatient Clinics
3200 Maccorkle Avenue SE
Charleston, WV 25304
Phone (304) 388-5590

Other identifiers 1

IdentifierTypeStateIssuer
7105184000MedicaidWV

Other names 1

  • Janice K Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060308000384 WV Practitioner - Nurse Practitioner 3476560970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Jan 4, 2016 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Jan 4, 2016 Accepting new patients
Charleston Cardiology Group PLLC Past Accepting new patients
Associated Radiologists, Inc. Past Accepting new patients

Locations

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

3200 Maccorkle Ave SE
Fl 5
Charleston, WV 25304
Phone (304) 388-1000

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1013982495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAMC OUTPATIENT CLINICS",
            "address_2": "3200 MACCORKLE AVENUE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-388-5590",
            "fax_number": "304-388-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE",
            "address_2": "SUITE 709",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-342-1184",
            "fax_number": "304-343-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "JANICE",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "29072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7105184000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "WILSON",
            "middle_name": "K",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.