NPIMap

Individual provider Active NPI

Karlie Perkins

  • Family Nurse Practitioner
  • Nitro, WV
National Provider Identifier
1336735679
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
108030 Issued in WV
Practice address
4114 1St Ave
Nitro, WV 25143-1304
Phone
(304) 755-0119
NPI assigned
Dec 20, 2020
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 108030 WV Primary

Addresses

Primary practice location

4114 1St Ave
Nitro, WV 25143-1304

Mailing address

4114 1St Ave
Nitro, WV 25143-1304

Other practice location 1

5240 MacCorkle Ave SE
Charleston, WV 25304-2122
Phone (304) 926-2300

Other names 1

  • Karlie Holmes 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
I20210401001891 WV Practitioner - Nurse Practitioner 6608283940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kanawha Hospice Care, IncGroup PAC ID 7416973805, 7 clinicians

Practice addresses (Care Compare)

1606 Kanawha Blvd W
Charleston, WV 25387-2536
Phone (304) 768-8523

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
108030WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kanawha Hospice Care, Inc CurrentSince Apr 15, 2022 Accepting new patients
Mountaineer Family Medicine, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Kanawha Hospice Care, Inc. CurrentSince Apr 15, 2022 Accepting new patients

Locations

1606 Kanawha Blvd W
Charleston, WV 25387
Phone (304) 768-8523

5240 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 926-2300

4114 1st Ave
Nitro, WV 25143
Phone (304) 755-0110

Organizations & group practices 3

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 12

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": "1608422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1336735679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 1ST AVE",
            "city": "NITRO",
            "state": "WV",
            "postal_code": "251431304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 1ST AVE",
            "city": "NITRO",
            "state": "WV",
            "postal_code": "251431304",
            "telephone_number": "304-755-0119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5240 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253042122",
            "country_code": "US",
            "telephone_number": "304-926-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "KARLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-20",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "108030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARLIE",
            "last_name": "HOLMES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nitro, WV

Sources for this page

Verify at the official NPI Registry.