Individual provider Active NPI

Christopher Kelly Vincent, M.D. PH.D.

  • Vascular Surgery Physician
  • Martinsburg, WV
National Provider Identifier
1275680266
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0101238773 Issued in VA
Practice address
510 Butler Ave
Department of Surgery
Martinsburg, WV 25405-9990
Phone
(304) 263-0811
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0101238773 VA Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 0101238773 VA

Addresses

Primary practice location

510 Butler Ave
Department of Surgery
Martinsburg, WV 25405-9990

Mailing address

510 Butler Ave
Department of Surgery
Martinsburg, WV 25405-9990
Phone (304) 263-0811

Other identifiers 2

IdentifierTypeStateIssuer
010405670MedicaidVA
P00453908OtherVAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20210514001752 VA Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 2365484615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101238773VAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiothoracic Surgeons of Roanoke Valley LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Dec 18, 2006 Accepting new patients
Cardiothoracic Surgeons Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Gulf Coast Hma Physician Management LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1275680266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 BUTLER AVE",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254059990",
            "telephone_number": "304-263-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BUTLER AVE",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254059990",
            "telephone_number": "304-263-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "CHRISTOPHER",
        "middle_name": "KELLY",
        "credential": "M.D. PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101238773",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "VA",
            "license": "0101238773",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010405670",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00453908",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.