Individual provider Active NPI

Kalyn Williams, LPN

  • Licensed Practical Nurse
  • Mount Hope, WV
National Provider Identifier
1104660364
Registry record updated Jun 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
39966 Issued in WV
Practice address
174 Valley CT Apt 7
Mount Hope, WV 25880-9294
Phone
(304) 575-0431
NPI assigned
Jun 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 39966 WV Primary

Addresses

Primary practice location

174 Valley CT Apt 7
Mount Hope, WV 25880-9294

Mailing address

174 Valley CT Apt 7
Mount Hope, WV 25880-9294
Phone (304) 575-0431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39966WVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1104660364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 VALLEY CT APT 7",
            "city": "MOUNT HOPE",
            "state": "WV",
            "postal_code": "258809294",
            "telephone_number": "304-575-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 VALLEY CT APT 7",
            "city": "MOUNT HOPE",
            "state": "WV",
            "postal_code": "258809294",
            "telephone_number": "304-575-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KALYN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "39966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Hope, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.