NPIMap

Individual provider Active NPI

Kevin D. Gladis, FNP-BC

  • Family Nurse Practitioner
  • Hurricane, WV
National Provider Identifier
1235482951
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
70686 Issued in WV
Practice address
3729 Teays Valley Rd Ste 100
Hurricane, WV 25526-9705
Phone
(304) 760-6040
Fax
(304) 760-6042
NPI assigned
Oct 18, 2012
Last updated
Jun 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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 70686 WV Primary

Addresses

Primary practice location

3729 Teays Valley Rd Ste 100
Hurricane, WV 25526-9705

Mailing address

PO Box 1680
Huntington, WV 25717-1680
Phone (304) 697-1396

Other identifiers 1

IdentifierTypeStateIssuer
3810024563MedicaidWV

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
I20121231000146 WV Practitioner - Nurse Practitioner 3971756800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
JC Edwards School of Medicine, Marshall University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

600 Tracy Way
Suite 2
Charleston, WV 25311-1262
Phone (304) 388-4965

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Feb 20, 2023 Accepting new patients
Point Pleasant Physician Billing Services CurrentSince May 1, 2015 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Feb 20, 2023 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

415 Morris St
Ste 309
Charleston, WV 25301
Phone (304) 348-3290

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

600 Tracy Way
Ste 2
Charleston, WV 25311
Phone (304) 346-8877

3703 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 757-2273

2520 Valley Dr
Ste 113
Pt Pleasant, WV 25550
Phone (304) 675-1020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1235482951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3729 TEAYS VALLEY RD STE 100",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269705",
            "telephone_number": "304-760-6040",
            "fax_number": "304-760-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADIS",
        "first_name": "KEVIN",
        "middle_name": "D.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "70686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810024563",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

Verify at the official NPI Registry.