NPIMap

Individual provider Active NPI

Sharon G. Lake, APRN, NP-C

  • Family Nurse Practitioner
  • South Charleston, WV
National Provider Identifier
1487033007
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
64723 Issued in WV
Practice address
4607 Maccorkle Ave SW
Suite 300
South Charleston, WV 25309-1364
Phone
(304) 766-3688
Fax
(304) 766-3484
NPI assigned
May 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 64723 WV Primary
Primary Care Nurse Practitioner 363LP2300X APRN64723 WV

Addresses

Primary practice location

4607 Maccorkle Ave SW
Suite 300
South Charleston, WV 25309-1364

Mailing address

204 Stone PL
Scott Depot, WV 25560-9465
Phone (304) 539-1298

Other practice location 1

4610 Kanawha Ave SW Ste 200
South Charleston, WV 25309-1367
Phone (304) 205-7992

Organizations & group practices 1

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 12

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Charleston Cardiology Associates 4 clinicians

Practice addresses (Care Compare)

4607 Maccorkle Ave SW
Suite 300
South Charleston, WV 25309-1364
Phone 3047663688300

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029

Merit-based Incentive Payment System (MIPS)

Final score
77.82 of 100Reported as group
Quality
55.65
Improvement activities
40

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
I20150828001757 WV Practitioner - Nurse Practitioner 8527374032 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64723WVMDFamily Nurse Practitioner
APRN64723WVMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Charleston Cardiology Associates CurrentSince Jun 9, 2015 Accepting new patients

Locations

4607 Maccorkle Ave SW
Ste 300
South Charleston, WV 25309
Phone (304) 766-3688

4607 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-2800

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1487033007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 STONE PL",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609465",
            "telephone_number": "304-539-1298",
            "fax_number": "304-766-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 MACCORKLE AVE SW",
            "address_2": "SUITE 300",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091364",
            "telephone_number": "304-766-3688",
            "fax_number": "304-766-3484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4610 Kanawha Ave SW Ste 200",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253091367",
            "country_code": "US",
            "telephone_number": "304-205-7992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE",
        "first_name": "SHARON",
        "middle_name": "G.",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "64723",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WV",
            "license": "APRN64723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.