Individual provider Active NPI

Kerry L. Bayer Cole, NP

  • Family Nurse Practitioner
  • Charles Town, WV
National Provider Identifier
1164475315
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
54825 Issued in WV
Practice address
710 Somerset Blvd Ste 103
Charles Town, WV 25414-4998
Phone
(304) 728-8661
Fax
(304) 728-8518
NPI assigned
May 18, 2006
Last updated
May 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 54825 WV Primary

Addresses

Primary practice location

710 Somerset Blvd Ste 103
Charles Town, WV 25414-4998

Mailing address

710 Somerset Blvd Ste 103
Charles Town, WV 25414-4998
Phone (304) 728-8661

Other practice location 1

365 Middleway Pike
Inwood, WV 25428-3809
Phone (304) 229-7930

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
I20040329000008 WV Practitioner - Nurse Practitioner 1456242494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

710 Somerset Blvd
Suite 103
Charles Town, WV 25414-4998
Phone (304) 728-8661

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54825WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arvessa Skin Care Center LLC CurrentSince Jun 1, 2020 Accepting new patients
Panhandle Medicine PLLC Past Accepting new patients
Mountain View Ear Nose and Throat PastSince Apr 1, 2007 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Robert Jones MD Past Accepting new patients

Locations

710 Somerset Blvd
Ste 103
Charles Town, WV 25414
Phone (301) 695-8346

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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 4

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1164475315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 SOMERSET BLVD STE 103",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144998",
            "telephone_number": "304-728-8661",
            "fax_number": "304-728-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 SOMERSET BLVD STE 103",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144998",
            "telephone_number": "304-728-8661",
            "fax_number": "304-728-8518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "365 Middleway Pike",
            "address_purpose": "LOCATION",
            "city": "Inwood",
            "state": "WV",
            "postal_code": "254283809",
            "country_code": "US",
            "telephone_number": "304-229-7930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "KERRY",
        "middle_name": "L. BAYER",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "54825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles Town, WV

Sources for this page

Verify at the official NPI Registry.