Justin Kiel Medlin, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

577 Issued in WV

Practice address

610 Chestnut St
South Charleston, WV 25309-1251

Phone

(304) 766-7515

Fax

(304) 766-7566

NPI assigned

Dec 5, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

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

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029
• Boone Memorial Hospital Hospital, Madison, WV, CCN 511313

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

Physician Assistant

State licenses

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.

• THS Physician Partners Inc

  • Internal Medicine Physician
  • South Charleston, WV
  • NPI 1871866806
  Medicare reassignment Care Compare group

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

• Boone Memorial Hospital, Inc

  • Critical Access Hospital
  • Madison, WV
  • NPI 1639135221
  Care Compare affiliation
• Herbert J. Thomas Memorial Hospital Association

  • General Acute Care Hospital
  • South Charleston, WV
  • NPI 1316925506
  Care Compare affiliation

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1538437629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-414-4800",
            "fax_number": "304-766-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 CHESTNUT ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091251",
            "telephone_number": "304-766-7515",
            "fax_number": "304-766-7566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11924 Winfield Rd",
            "address_purpose": "LOCATION",
            "city": "Winfield",
            "state": "WV",
            "postal_code": "252137913",
            "country_code": "US",
            "telephone_number": "304-767-7790",
            "fax_number": "304-767-7566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4605 MacCorkle Ave SW",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253091311",
            "country_code": "US",
            "telephone_number": "304-414-4800",
            "fax_number": "304-766-7566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDLIN",
        "first_name": "JUSTIN",
        "middle_name": "KIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-05",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin.medlin@thomashealthsystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "11924 Winfield Rd",
            "city": "Winfield",
            "state": "WV",
            "country_code": "US",
            "postal_code": "252137913",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin.medlin@thomashealthsystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "610 Chestnut St",
            "city": "South Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253091251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin.medlin@thomashealthsystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "4605 MacCorkle Ave SW",
            "city": "South Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253091311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Roxie Means
• Sarah Ashley Means
• Skilar Faithidallas Means
• Robert Mears, PHYSICAL THERAPIST
• Medexpress Urgent Care, Inc - West Virginia
• Nayana R. Megha, M.D.
• Melissa N. Bacchus, MD, PLLC
• Ashley Ebersole Mellert, PA-C
• Robert Meraki
• Veta Merritt

• Surgical Physician Assistant in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Surgical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.