Individual provider Active NPI

Kimberly Dawn Hughes, CNP

  • Family Nurse Practitioner
  • Gallipolis, OH
National Provider Identifier
1629276126
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA-12485-NP Issued in OH
Practice address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone
(740) 446-5371
Fax
(740) 446-5711
NPI assigned
Jul 5, 2007
Last updated
Aug 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA-12485-NP OH Primary

Addresses

Primary practice location

90 Jackson Pike
Gallipolis, OH 45631-1560

Mailing address

90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5371

Other identifiers 3

IdentifierTypeStateIssuer
3810024034MedicaidWV
0068690MedicaidOH
310917085302OtherOHOHIO MEDICAID CARESOURCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120801000105 OH Practitioner - Nurse Practitioner 6800052168 Reassigns benefits to 1 organization
Practice locations: Jackson, OH

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 E Main St
Jackson, OH 45640-1716
Phone (740) 286-5094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA-12485-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Jackson CurrentSince Jun 22, 2024 Accepting new patients
Community Action Committee of Pike County Past Accepting new patients
Hope NP House Call Practice PastSince Nov 1, 2017 Accepting new patients

Locations

102 Twin Oaks Dr
Jackson, OH 45640
Phone (740) 286-5094

200 E Main St
Jackson, OH 45640
Phone (614) 286-5094

Interoperability endpoints

  • Direct secure messaging: kim.hughes.1@16701.direct.athenahealth.com
  • Direct secure messaging: kimberly.hughes.1@26894.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1629276126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5371",
            "fax_number": "740-446-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5371",
            "fax_number": "740-446-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA-12485-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810024034",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068690",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAID CARESOURCE",
            "identifier": "310917085302",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.