Individual provider Active NPI

Kelsey Christine Thornton, APRN

  • Adult Health Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1508611559
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
79693 Issued in WV
Practice address
3415 Maccorkle Ave SE
Charleston, WV 25304-1334
Phone
(304) 388-8380
NPI assigned
Apr 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 79693 WV Primary

Addresses

Primary practice location

3415 Maccorkle Ave SE
Charleston, WV 25304-1334

Mailing address

3200 Maccorkle Ave SE
Charleston, WV 25304-1227

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251218003265 WV Practitioner - Nurse Practitioner 8123513983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
79693WVMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Sep 5, 2025 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1508611559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041334",
            "telephone_number": "304-388-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "KELSEY",
        "middle_name": "CHRISTINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WV",
            "license": "79693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.