NPIMap

Individual provider Active NPI

Kishore K. Challa, M.D., F.A.C.C.

  • Interventional Cardiology Physician
  • So Charleston, WV
National Provider Identifier
1043377062
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
15721 Issued in WV
Practice address
4607 Maccorkle Avenue SW
Suite 300
So Charleston, WV 25309-1364
Phone
(304) 766-3688
Fax
(304) 766-3484
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 15721 WV
Interventional Cardiology Physician 207RI0011X 15721 WV Primary

Addresses

Primary practice location

4607 Maccorkle Avenue SW
Suite 300
So Charleston, WV 25309-1364

Mailing address

4607 Maccorkle Avenue SW
Suite 300
South Charleston, WV 25309-1364
Phone (304) 766-3688

Other practice location 1

4605 MacCorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419000219 WV Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0840285953 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners Inc 366 clinicians
South Charleston Cardiology Associates 4 clinicians

Practice addresses (Care Compare)

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

4607 Maccorkle Ave SW
Suite 300
South Charleston, WV 25309-1364
Phone 3047663688300

Hospital & facility affiliations

  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029
  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001
  • Jackson General Hospital Hospital, Ripley, WV, CCN 511320
  • Roane General Hospital Hospital, Spencer, WV, CCN 511306

Merit-based Incentive Payment System (MIPS)

Final score
77.82 of 100Reported as group
Quality
55.65
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15721WVMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
THS Physician Partners Inc CurrentSince May 15, 2022 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Nov 10, 2012 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Nov 10, 2012 Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

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

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

4607 Maccorkle Ave SW
Ste 300
South Charleston, WV 25309
Phone (304) 766-3688

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Thomas Memorial HospitalSouth Charleston, WV, CCN 510029 Hospital Corporate Director Apr 28, 2016
Thomas Hospitals Skilled Nursing UnitCharleston, WV, CCN 515110 Skilled nursing facility Corporate Director
Operational/Managerial Control		 May 1, 2024
May 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1043377062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 MACCORKLE AVENUE SW",
            "address_2": "SUITE 300",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091364",
            "telephone_number": "304-766-3688",
            "fax_number": "304-766-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 MACCORKLE AVENUE SW",
            "address_2": "SUITE 300",
            "city": "SO CHARLESTON",
            "state": "WV",
            "postal_code": "253091364",
            "telephone_number": "304-766-3688",
            "fax_number": "304-766-3484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4605 MacCorkle Ave SW",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253091311",
            "country_code": "US",
            "telephone_number": "304-414-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHALLA",
        "first_name": "KISHORE",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WV",
            "license": "15721",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WV",
            "license": "15721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in So Charleston, WV

Sources for this page

Verify at the official NPI Registry.