Kristen D Shamblin, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

63250 Issued in WV

Practice address

331 Laidley St
Charleston, WV 25301-1619

Phone

(304) 720-7234

Fax

(304) 720-7236

NPI assigned

Nov 5, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Alignmed Medical Group WV, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Fairmont, WV
  • NPI 1003647462
  Medicare reassignment NPD
• Geps Physician Group of West Virginia PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Follansbee, WV
  • NPI 1457729212
  Medicare reassignment NPD
• Alignmed Partners, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gardendale, AL
  • NPI 1881109452

  WV

  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Charleston, PLLC

  • Internal Medicine Physician
  • Charleston, WV
  • NPI 1760535702
  NPD (past)
• WV PHS Medical Corporation

  • Family Medicine Physician
  • Charleston, WV
  • NPI 1881907004
  NPD (past)

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1295989119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CHESTNUT LN",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251779790",
            "telephone_number": "304-549-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 LAIDLEY ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011619",
            "telephone_number": "304-720-7234",
            "fax_number": "304-720-7236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBLIN",
        "first_name": "KRISTEN",
        "middle_name": "D",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "63250",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "63250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1295989119",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy R Shaluta, BS
• Shreya Shambhavi, M.D.
• Samera Shamblen
• Brittany Shamblin
• Herschel Gene Shamblin
• Lisa Shamblin
• Summer Shamblin
• Taylor Shamblin
• Trevor Allan Shamblin
• Allison Nicole Shamma

• Family Nurse Practitioner in Charleston, WV
• Providers in Charleston, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.