Individual provider Active NPI

Kelly Hebb, LPN

  • Licensed Practical Nurse
  • Buckhannon, WV
National Provider Identifier
1306739735
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
35797 Issued in WV
Practice address
79 Clover Grove Dr
Buckhannon, WV 26201-4719
Phone
(304) 516-0494
NPI assigned
Jun 3, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35797WVMDLicensed Practical Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 35797 WV Primary

Addresses

NPPES NPI Registry

Primary practice location

79 Clover Grove Dr
Buckhannon, WV 26201-4719

Mailing address

79 Clover Grove Dr
Buckhannon, WV 26201-4719
Phone (304) 516-0494

Other names 1

NPPES NPI Registry
  • Kelly Everson Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 3, 2025.

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1306739735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 CLOVER GROVE DR",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262014719",
            "telephone_number": "304-516-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 CLOVER GROVE DR",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262014719",
            "telephone_number": "304-516-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBB",
        "first_name": "KELLY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "35797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "EVERSON",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buckhannon, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.