NPIMap

Individual provider Active NPI

Katrina Rose Tilton, C-NP

  • Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1205335569
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
111820 Issued in WV
Practice address
3100 Maccorkle Ave SE Ste 205
Charleston, WV 25304-1228
Phone
(304) 388-2390
NPI assigned
Feb 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 111820 WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE Ste 205
Charleston, WV 25304-1228

Mailing address

3100 Maccorkle Ave SE Ste 205
Charleston, WV 25304-1228
Phone (304) 388-2390

Other identifiers 1

IdentifierTypeStateIssuer
0242047MedicaidOH

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
I20260313001647 WV Practitioner - Nurse Practitioner 8022591411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Area Medical Center IncGroup PAC ID 3375441637, 969 clinicians

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-7823

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111820WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Jan 12, 2026 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Jan 12, 2026 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

3100 Maccorkle Ave SE
Ste 205
Charleston, WV 25304
Phone (304) 388-2303

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700

Organizations & group practices 3

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 11

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": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1205335569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 205",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041228",
            "telephone_number": "304-388-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 205",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041228",
            "telephone_number": "304-388-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILTON",
        "first_name": "KATRINA",
        "middle_name": "ROSE",
        "credential": "C-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "111820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0242047",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.