Individual provider Active NPI

Kimberly Ewing, MD

  • Emergency Medicine Physician
  • Charleston, WV
National Provider Identifier
1265419279
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
15806 Issued in WV
Practice address
800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone
(304) 388-2550
NPI assigned
Dec 30, 2005
Last updated
Jan 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 15806 WV Primary

Addresses

Primary practice location

800 Pennsylvania Ave
Charleston, WV 25302-3351

Mailing address

800 Pennsylvia Avenue
Charleston, WV 25302
Phone (304) 388-2550

Other identifiers 3

IdentifierTypeStateIssuer
1053227OtherWVWV DWC
001718051OtherWVWV BCBS
0106293000MedicaidWV

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060309000024 WV Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 2062429533 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Jan 1, 2017 Accepting new patients

Locations

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

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

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

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1265419279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PENNSYLVIA AVENUE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25302",
            "telephone_number": "304-388-2550",
            "fax_number": "304-388-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PENNSYLVANIA AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023351",
            "telephone_number": "304-388-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWING",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "15806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV DWC",
            "identifier": "1053227",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BCBS",
            "identifier": "001718051",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106293000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.