NPIMap

Individual provider Active NPI

Kimberly D. Coles, APRN-CNP

  • Gerontology Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1619401841
Registry record updated Mar 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN70668-AGPCNP-BC Issued in WV
Practice address
3100 Maccorkle Ave SE Ste 900
Charleston, WV 25304-1223
Phone
(304) 388-5880
Fax
(304) 388-5858
NPI assigned
Apr 14, 2017
Last updated
Mar 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN70668 WV
Gerontology Nurse Practitioner 363LG0600X APRN70668-AGPCNP-BC WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE Ste 900
Charleston, WV 25304-1223

Mailing address

3100 Maccorkle Ave SE Ste 900
Charleston, WV 25304-1223
Phone (304) 388-5880

Other practice location 1

4607 MacCorkle Ave SW
Suite 300
South Charleston, WV 25309-1364
Phone (304) 766-3688

Other practice location 2

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Other practice location 3

940 4th Ave Ste 600
Huntington, WV 25701-0065
Phone (304) 529-7004

Other practice location 4

3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Other names 1

  • Kimberly Dawn Coles Other name

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
I20180424001851 WV Practitioner - Nurse Practitioner 9537422688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3100 Maccorkle Ave SE
Suite 900
Charleston, WV 25304-1223
Phone (304) 388-5880

Hospital & facility affiliations

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN70668-AGPCNP-BCWVMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Feb 24, 2020 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Feb 24, 2020 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

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

Organizations & group practices 3

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1619401841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 900",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-388-5880",
            "fax_number": "304-388-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 900",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-388-5880",
            "fax_number": "304-388-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4607 MacCorkle Ave SW",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253091364",
            "country_code": "US",
            "telephone_number": "304-766-3688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "940 4th Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257010065",
            "country_code": "US",
            "telephone_number": "304-529-7004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041227",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLES",
        "first_name": "KIMBERLY",
        "middle_name": "D.",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "APRN70668",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WV",
            "license": "APRN70668-AGPCNP-BC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "COLES",
            "middle_name": "DAWN",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.