NPIMap

Individual provider Active NPI

Kara Darlene Carpenter, PA C

  • Medical Physician Assistant
  • Charleston, WV
National Provider Identifier
1245228501
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
01058 Issued in WV
Practice address
303 Ohio Ave
Charleston, WV 25302-2212
Phone
(681) 205-8701
Fax
(681) 208-8702
NPI assigned
Oct 11, 2005
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 01058 WV
Medical Physician Assistant 363AM0700X 01058 WV Primary

Addresses

Primary practice location

303 Ohio Ave
Charleston, WV 25302-2212

Mailing address

104 Alex LN
Charleston, WV 25304-2952
Phone (304) 734-2040

Other identifiers 5

IdentifierTypeStateIssuer
0107132MedicaidOH
1069109OtherWVWV DWC
001720818OtherWVBLUE CROSS BLUE SHIELD
7100274210MedicaidKY
1245228501MedicaidWV

Other names 1

  • Ms. Kara Darlene Bryan Other name

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
I20040723000774 WV Practitioner - Physician Assistant 5092795518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cabin Creek Health Center IncGroup PAC ID 2466431101, 41 clinicians

Practice addresses (Care Compare)

107 Koontz Ave
Suite 200
Clendenin, WV 25045-9581
Phone (304) 548-7272

303 Ohio Ave
Charleston, WV 25302-2212
Phone 30473420401301

6135 Sissonville Dr
Charleston, WV 25312-9444
Phone (304) 984-1576

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
01058WVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cabin Creek Health Center, Inc. CurrentSince Oct 14, 2024 Accepting new patients
Cabin Creek Health Center Inc CurrentSince Oct 14, 2024 Accepting new patients
Cabin Creek Health Center, Inc. Past Accepting new patients
Teays Valley Emergency Physicians, Inc Physician Assistant Past Accepting new patients
New Century Emergency Physician of West Virginia Inc Physician Assistant Past Accepting new patients

Locations

1 Warrior Way
Ste 103
Belle, WV 25015
Phone (304) 949-3591

104 Alex Ln
Charleston, WV 25304
Phone 30473420401319

4602 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 205-7535

6135 Sissonville Dr
Charleston, WV 25312
Phone (304) 343-8030

107 Koontz Ave
Ste 200
Clendenin, WV 25045
Phone (304) 548-7272

Interoperability endpoints

  • Direct secure messaging: kara.carpenter.1@7267.direct.athenahealth.com

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 12

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1245228501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ALEX LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042952",
            "telephone_number": "304-734-2040",
            "fax_number": "304-734-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 OHIO AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022212",
            "telephone_number": "681-205-8701",
            "fax_number": "681-208-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "KARA",
        "middle_name": "DARLENE",
        "name_prefix": "Mrs.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01058",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "01058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107132",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV DWC",
            "identifier": "1069109",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001720818",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100274210",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245228501",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARA",
            "last_name": "BRYAN",
            "middle_name": "DARLENE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.