Individual provider Active NPI

Kevin Kimmins, CRNA

  • Certified Registered Nurse Anesthetist
  • Weirton, WV
National Provider Identifier
1376687764
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
59986 Issued in WV
Practice address
601 Colliers Way
Weirton, WV 26062-5014
Phone
(304) 797-6000
NPI assigned
Feb 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 59986 WV Primary

Addresses

Primary practice location

601 Colliers Way
Weirton, WV 26062-5014

Mailing address

601 Colliers Way
Weirton, WV 26062-5014
Phone (304) 797-6000

Other identifiers 2

IdentifierTypeStateIssuer
550387249OtherTAX ID
38010004792MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051129000784 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173543675 Reassigns benefits to 2 organizations
I20110526000663 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173543675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians
Wheeling Hospital Ambulatory Surgery Center LLCGroup PAC ID 8123354743, 25 clinicians

Practice addresses (Care Compare)

1 Medical Park
Wheeling, WV 26003-6379
Phone (304) 243-3343

68 State Route 7
Bridgeport, OH 43912-1642
Phone (740) 676-6600

Hospital & facility affiliations

  • Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
59986WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Reynolds Memorial Hospital, Inc CurrentSince May 12, 2024 Accepting new patients
Wheeling Hospital Ambulatory Surgery Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients
Wheeling Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Dec 6, 2010 Accepting new patients
Weirton Medical Center Past Accepting new patients
Weirton Medical Center, Inc Past Accepting new patients

Locations

68 State Route 7
Bridgeport, OH 43912
Phone (740) 676-6600

800 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-4520

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

109 Mount Wood Rd
#1
Wheeling, WV 26003

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ea592379-b0ed-4cfa-aa0c-6e5256a40b54/

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376687764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 COLLIERS WAY",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625014",
            "telephone_number": "304-797-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 COLLIERS WAY",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625014",
            "telephone_number": "304-797-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMINS",
        "first_name": "KEVIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "59986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "550387249",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38010004792",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.