Kimberly Ann Wallace, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

74136 Issued in WV

Practice address

1 Medical Center Drive
Morgantown, WV 26506

Phone

(304) 598-4000

NPI assigned

Dec 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

West Virginia University Medical CorporationGroup PAC ID 1052224565, 1,974 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001
• United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006
• Davis Medical Center Hospital, Elkins, WV, CCN 510030

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• West Virginia University Medical Corporation

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508
  Medicare reassignment Care Compare group NPD
• West Virginia University Medical Corporation

  • Community/Behavioral Health Agency
  • Martinsburg, WV
  • NPI 1174233530
  NPD
• Wvu Med Corp Cheat Lake Physicians

  • Clinical Medical Laboratory
  • Morgantown, WV
  • NPI 1568661148
  NPD

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

• Davis Memorial Hospital

  • General Acute Care Hospital
  • Elkins, WV
  • NPI 1619964806
  Care Compare affiliation
• United Hospital Center, Inc

  • General Acute Care Hospital
  • Bridgeport, WV
  • NPI 1184606600
  Care Compare affiliation
• West Virginia University Hospitals, Inc

  • General Acute Care Hospital
  • Morgantown, WV
  • NPI 1841271459
  Care Compare affiliation

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1457697435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-598-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-598-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-20",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "74136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Walker, RN
• Nicole Walker
• Nikita Sue-Ann Walker
• Andrew Wall, MD
• Amanda Wallace
• Janet Walleck, CRNA
• Wallflower Connection Therapy Services PLLC
• Barry David Walling, MD
• Elizabeth Walling, LGSW
• Madison Walling, PHARMD

• Family Nurse Practitioner in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.