NPIMap

Individual provider Active NPI

Karen Lynn Bailey, PA-C

  • Physician Assistant
  • Charleston, WV
National Provider Identifier
1285988808
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
742 Issued in WV
Practice address
4602 Maccorkle Ave SE
81 Lincoln Panther Way
Charleston, WV 25304-1848
Phone
(304) 205-7535
Fax
(304) 205-7536
NPI assigned
Nov 5, 2012
Last updated
May 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 742 WV Primary

Addresses

Primary practice location

4602 Maccorkle Ave SE
81 Lincoln Panther Way
Charleston, WV 25304-1848

Mailing address

4602 Maccorkle Ave SE
Charleston, WV 25304-1848
Phone (304) 205-7535

Other identifiers 1

IdentifierTypeStateIssuer
3810025370MedicaidWV

Other names 1

  • Miss Karen Lynn Mantz Former 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
I20130222000505 WV Practitioner - Physician Assistant 0244485241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2930 Chesterfield Ave
Charleston, WV 25304-1125
Phone (304) 351-1700

400 Association Dr
Suite 102
Charleston, WV 25311-1298

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
742WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince May 2, 2025 Accepting new patients
Cabin Creek Health Center, Inc. CurrentSince Jun 25, 2017 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince May 2, 2025 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

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

4602 Maccorkle Ave SE
#81
Charleston, WV 25304
Phone (304) 205-7535

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

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

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

Organizations & group practices 6

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": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1285988808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041848",
            "telephone_number": "304-205-7535",
            "fax_number": "304-205-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 MACCORKLE AVE SE",
            "address_2": "81 LINCOLN PANTHER WAY",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041848",
            "telephone_number": "304-205-7535",
            "fax_number": "304-205-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810025370",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "MANTZ",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.