Individual provider Active NPI

Caitlyn Elizabeth Nelson, D.D.S

  • General Practice Dentistry
  • Clendenin, WV
National Provider Identifier
1043660160
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4260 Issued in WV
Practice address
107 Koontz Ave Ste 200
Clendenin, WV 25045
Phone
(304) 548-2160
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4260 WV Primary

Addresses

Primary practice location

107 Koontz Ave Ste 200
Clendenin, WV 25045

Mailing address

711 Myrtle Rd
Charleston, WV 25314-1117
Phone (304) 767-5464

Other practice location 1

1220 Lee St E
Charleston, WV 25301-1863
Phone (304) 388-1800

Other practice location 2

415 Morris St Ste 309
Charleston, WV 25301-1853
Phone (304) 388-3290

Other practice location 3

830 Pennsylvania Ave Ste 302
Charleston, WV 25302-3390
Phone (304) 388-2950

Other practice location 4

121 Hendersonville Rd
Asheville, NC 28803-2868
Phone (304) 767-5464

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address caitlyn.nelson@camc.cernerdirect.com
Direct Messaging Address caitlyn.nelson@camc.cernerdirect.com
Direct Messaging Address caitlyn.nelson@camc.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260522002280 WV Practitioner - Dentist 6901285949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
West Virginia University School of Dentistry, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12910 Shelbyville Rd
Suite 300
Louisville, KY 40243-2404

400 Association Dr
Charleston, WV 25311-1295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: caitlyn.nelson@camc.cernerdirect.com
  • FHIR API: https://api.platform.athenahealth.com/7267/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1043660160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 MYRTLE RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141117",
            "telephone_number": "304-767-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 KOONTZ AVE STE 200",
            "city": "CLENDENIN",
            "state": "WV",
            "postal_code": "25045",
            "telephone_number": "304-548-2160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Lee St E",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011863",
            "country_code": "US",
            "telephone_number": "304-388-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 Morris St Ste 309",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011853",
            "country_code": "US",
            "telephone_number": "304-388-3290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 Pennsylvania Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253023390",
            "country_code": "US",
            "telephone_number": "304-388-2950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "121 Hendersonville Rd",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288032868",
            "country_code": "US",
            "telephone_number": "304-767-5464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CAITLYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "caitlyn.nelson@camc.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1220 Lee St E",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253011863",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "caitlyn.nelson@camc.cernerdirect.com",
            "affiliation": "N",
            "address_1": "415 Morris St Ste 309",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253011853",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "caitlyn.nelson@camc.cernerdirect.com",
            "affiliation": "N",
            "address_1": "830 Pennsylvania Ave Ste 302",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253023390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clendenin, WV

Sources for this page

Verify at the official NPI Registry.