NPIMap

Individual provider Active NPI

Kenneth Neil Dippel, P.A. -C

  • Medical Physician Assistant
  • Charleston, WV
National Provider Identifier
1073662664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
00710 Issued in WV
Practice address
3200 Maccorkle Ave. SE
Camc Memorial Hospital
Charleston, WV 25304
Phone
(304) 388-8199
Fax
(304) 388-8195
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 00710 WV Primary

Addresses

Primary practice location

3200 Maccorkle Ave. SE
Camc Memorial Hospital
Charleston, WV 25304

Mailing address

811 Somerset Dr
Charleston, WV 25302-2735
Phone (304) 346-4311

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
I20060320000210 WV Practitioner - Physician Assistant 2961419783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1836 Harper Rd
Beckley, WV 25801-3366
Phone (304) 250-0200

1838 Harper Rd
Beckley, WV 25801-3366
Phone (304) 388-9337

1844 Harper Rd
Beckley, WV 25801-3366

3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

400 Association Dr
Suite 102
Charleston, WV 25311-1298

415 Morris St
Charleston, WV 25301-1853

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Hospital & facility affiliations

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00710WVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Jan 1, 2006 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

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073662664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 SOMERSET DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022735",
            "telephone_number": "304-346-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE. SE",
            "address_2": "CAMC MEMORIAL HOSPITAL",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-388-8199",
            "fax_number": "304-388-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPPEL",
        "first_name": "KENNETH",
        "middle_name": "NEIL",
        "name_prefix": "Mr.",
        "credential": "P.A. -C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "00710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.