NPIMap

Individual provider Active NPI

Kelley N Ross, FNP-BC

  • Family Nurse Practitioner
  • Spencer, WV
National Provider Identifier
1306084728
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN58584 Issued in WV
Practice address
200 Hospital Dr
Spencer, WV 25276-1050
Phone
(304) 927-6812
Fax
(304) 927-6393
NPI assigned
Jan 22, 2009
Last updated
Jan 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 58584 WV
Family Nurse Practitioner 363LF0000X APRN58584 WV Primary

Addresses

Primary practice location

200 Hospital Dr
Spencer, WV 25276-1050

Mailing address

200 Hospital Dr
Spencer, WV 25276-1050
Phone (304) 927-4444

Other practice location 1

1 Library LN
Ste 2
Left Hand, WV 25251
Phone (304) 927-6342

Other practice location 2

94 School Dr
Walton, WV 25286-9774
Phone (304) 927-6342

Other practice location 3

1024 Arnoldsburg Rd
Arnoldsburg, WV 25234
Phone (304) 655-6742

Other practice location 4

300 Hospital Dr
Spencer, WV 25276-1049
Phone (304) 927-6342

Other names 1

  • Kelley Nichole Smith 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
I20231117001416 WV Practitioner - Nurse Practitioner 7810117363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Development Co.Group PAC ID 4183527476, shared by 9 NPIs, 65 clinicians

Practice addresses (Care Compare)

200 Hospital Dr
Spencer, WV 25276-1050
Phone (304) 927-4444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
58584WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Development Co CurrentSince Sep 2, 2023 Accepting new patients
Hospital Development Co CurrentSince Sep 2, 2023 Accepting new patients
Hospital Development Co CurrentSince Dec 4, 2025 Accepting new patients
Hospital Development Co Current Accepting new patients
Hospital Development Co Current Accepting new patients
Hospital Development Co Past Accepting new patients

Locations

1024 Arnoldsburg Rd
Arnoldsburg, WV 25234
Phone (304) 655-6742

200 Hospital Dr
Spencer, WV 25276
Phone (304) 927-4444

300 Hospital Dr
Spencer, WV 25276
Phone (304) 891-2021

94 School Dr
Walton, WV 25286
Phone (304) 577-6815

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1306084728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761050",
            "telephone_number": "304-927-4444",
            "fax_number": "304-927-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761050",
            "telephone_number": "304-927-6812",
            "fax_number": "304-927-6393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 LIBRARY LN",
            "address_2": "STE 2",
            "address_purpose": "LOCATION",
            "city": "LEFT HAND",
            "state": "WV",
            "postal_code": "25251",
            "country_code": "US",
            "telephone_number": "304-927-6342",
            "fax_number": "304-565-3154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "94 School Dr",
            "address_purpose": "LOCATION",
            "city": "Walton",
            "state": "WV",
            "postal_code": "252869774",
            "country_code": "US",
            "telephone_number": "304-927-6342",
            "fax_number": "304-577-6951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1024 ARNOLDSBURG RD",
            "address_purpose": "LOCATION",
            "city": "ARNOLDSBURG",
            "state": "WV",
            "postal_code": "25234",
            "country_code": "US",
            "telephone_number": "304-655-6742",
            "fax_number": "304-655-6743",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Spencer",
            "state": "WV",
            "postal_code": "252761049",
            "country_code": "US",
            "telephone_number": "304-927-6342",
            "fax_number": "304-927-6803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KELLEY",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2024-01-02",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "58584",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN58584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "SMITH",
            "middle_name": "NICHOLE",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spencer, WV

Sources for this page

Verify at the official NPI Registry.