NPIMap

Individual provider Active NPI

Justin Wayne Kauffman, MSN, ACNPC-AG, APRN

  • Acute Care Nurse Practitioner
  • Ashland, KY
National Provider Identifier
1619702644
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4046715 Issued in KY
Practice address
613 23Rd St Ste G10
Ashland, KY 41101-2886
Phone
(606) 408-5864
Fax
(606) 408-6499
NPI assigned
Sep 9, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4046715 KY Primary
Acute Care Nurse Practitioner 363LA2100X 120808 WV

Addresses

Primary practice location

613 23Rd St Ste G10
Ashland, KY 41101-2886

Mailing address

1428 Township Road 97
Willow Wood, OH 45696-8904
Phone (740) 361-8220

Other practice location 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241016000750 WV Practitioner - Nurse Practitioner 0143752170 Reassigns benefits to 1 organization
I20251121003890 KY Practitioner - Nurse Practitioner 0143752170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
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)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-7823

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
4046715KYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc CurrentSince Nov 17, 2025 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Kings Daughters Medical Specialties Inc., CurrentSince Nov 17, 2025 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Sep 1, 2024 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

613 23rd St
Ste G10
Ashland, KY 41101
Phone (606) 329-1997

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

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

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

Organizations & group practices 5

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": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1619702644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 TOWNSHIP ROAD 97",
            "city": "WILLOW WOOD",
            "state": "OH",
            "postal_code": "456968904",
            "telephone_number": "740-361-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 23RD ST STE G10",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012886",
            "telephone_number": "606-408-5864",
            "fax_number": "606-408-6499"
        }
    ],
    "practiceLocations": [
        {
            "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"
        }
    ],
    "basic": {
        "last_name": "KAUFFMAN",
        "first_name": "JUSTIN",
        "middle_name": "WAYNE",
        "credential": "MSN, ACNPC-AG, APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-09",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "4046715",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WV",
            "license": "120808",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.