NPIMap

Individual provider Active NPI

Monica Gene Higginbotham, FNP-C

  • Nurse Practitioner
  • South Charleston, WV
National Provider Identifier
1386121374
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN70740NP Issued in WV
Practice address
4610 Kanawha Ave SW Ste 200
South Charleston, WV 25309-1367
Phone
(304) 205-7992
Fax
(304) 205-7739
NPI assigned
Jul 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN70740NP WV Primary

Addresses

Primary practice location

4610 Kanawha Ave SW Ste 200
South Charleston, WV 25309-1367

Mailing address

1532 Bridge Rd Apt F
Charleston, WV 25314-1900
Phone (304) 382-7662

Other practice location 1

3100 MacCorkle Ave SE Ste 101
Charleston, WV 25304-1215

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
I20181002003392 WV Practitioner - Nurse Practitioner 9133471162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3100 Maccorkle Ave SE
Suite 101
Charleston, WV 25304-1215
Phone (304) 388-5590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN70740NPWVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Aug 20, 2018 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Aug 20, 2018 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

3100 Maccorkle Ave SE
Ste 101
Charleston, WV 25304
Phone (304) 388-5395

4610 Kanawha Ave SW
Ste 200
South Charleston, WV 25309
Phone (304) 205-7992

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1386121374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 BRIDGE RD APT F",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141900",
            "telephone_number": "304-382-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 KANAWHA AVE SW STE 200",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091367",
            "telephone_number": "304-205-7992",
            "fax_number": "304-205-7739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 MacCorkle Ave SE Ste 101",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041215",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "MONICA",
        "middle_name": "GENE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "APRN70740NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.