Active NPI
Kimberly N Bogar, APRN, FNP-C
- Family Nurse Practitioner
- Williamson, WV
National Provider Identifier
1477939825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3009592
- Practice address
- 1609 W 3Rd Ave
Williamson, WV 25661-3006 - Phone
- (304) 235-0026
- Fax
- (304) 235-0028
- NPI assigned
- Aug 8, 2015
- Last updated
- Oct 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3009592 | KY | Primary |
Addresses
Primary practice location
1609 W 3Rd Ave
Williamson, WV 25661-3006
Mailing address
1609 W 3Rd Ave
Williamson, WV 25661-3006
Phone (304) 235-0026
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3009592 | Other | KY | APRN |
| 1107444 | Other | KY | RN |
| 94824 | Other | WV | APRN/RN |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3009592 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Williamson Treatment Center, LLC | Past | Accepting new patients | |
| Williamson Treatment Center, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Methadone Clinic
- Williamson, WV
- NPI 1689189490
-
- Methadone Clinic
- Williamson, WV
- NPI 1710389655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1477939825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1609 W 3RD AVE",
"city": "WILLIAMSON",
"state": "WV",
"postal_code": "256613006",
"telephone_number": "304-235-0026",
"fax_number": "304-235-0028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 W 3RD AVE",
"city": "WILLIAMSON",
"state": "WV",
"postal_code": "256613006",
"telephone_number": "304-235-0026",
"fax_number": "304-235-0028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGAR",
"first_name": "KIMBERLY",
"middle_name": "N",
"credential": "APRN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-08",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3009592",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APRN",
"identifier": "3009592",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "1107444",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APRN/RN",
"identifier": "94824",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamson, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.