NPIMap

Individual provider Active NPI

Shelby Kay Hicks, APRN-CNP

  • Adult Health Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1518533751
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
108406 Issued in WV
Practice address
2930 Chesterfield Ave
Charleston, WV 25304-1125
Phone
(304) 351-1700
NPI assigned
May 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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 108406 WV Primary

Addresses

Primary practice location

2930 Chesterfield Ave
Charleston, WV 25304-1125

Mailing address

43 Elberta Dr
Charleston, WV 25306-9189
Phone (304) 541-9780

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
I20210618000288 WV Practitioner - Nurse Practitioner 8224438874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Area Medical Center IncGroup PAC ID 3375441637, 969 clinicians

Practice addresses (Care Compare)

2930 Chesterfield Ave
Charleston, WV 25304-1125
Phone (304) 351-1700

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022

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
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
108406WVMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Jun 23, 2021 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Jun 23, 2021 Accepting new patients

Locations

2930 Chesterfield Ave
Charleston, WV 25304
Phone (304) 343-9923

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

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.

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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1518533751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 ELBERTA DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253069189",
            "telephone_number": "304-541-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 CHESTERFIELD AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041125",
            "telephone_number": "304-351-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "SHELBY",
        "middle_name": "KAY",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WV",
            "license": "108406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.