Individual provider Active NPI

Kaylin Mathews, FNP

  • Family Nurse Practitioner
  • Kingwood, WV
National Provider Identifier
1114781549
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
121424 Issued in WV
Practice address
150 Memorial Dr
Kingwood, WV 26537-1141
Phone
(304) 329-4701
NPI assigned
Feb 7, 2024
Last updated
Jan 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 121424 WV Primary
Registered Nurse 163W00000X 74640 WV

Addresses

Primary practice location

150 Memorial Dr
Kingwood, WV 26537-1141

Mailing address

150 Memorial Dr
Kingwood, WV 26537-1141
Phone (304) 329-1400

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250213002662 WV Practitioner - Nurse Practitioner 4880124205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preston Memorial Hospital CorporationGroup PAC ID 5294645107, shared by 3 NPIs, 46 clinicians

Practice addresses (Care Compare)

150 Memorial Dr
Kingwood, WV 26537-1141
Phone (304) 329-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74640WVMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Memorial Hospital Corporation CurrentSince Feb 3, 2025 Accepting new patients
Preston Memorial Hospital Corporation CurrentSince Feb 3, 2025 Accepting new patients

Locations

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/preston-adacdb24

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1114781549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MEMORIAL DR",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371141",
            "telephone_number": "304-329-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MEMORIAL DR",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371141",
            "telephone_number": "304-329-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "KAYLIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "121424",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "74640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, WV

Sources for this page

Verify at the official NPI Registry.