Individual provider Active NPI

Kathleen M. Kinney, NP

  • Neonatal Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1629372651
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
71003489 Issued in IN
Practice address
705 Riley Hospital Dr
RR 208
Indianapolis, IN 46202-5109
Phone
(317) 274-4715
Fax
(317) 274-2065
NPI assigned
Jan 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 28193751 IN
Neonatal Nurse Practitioner 363LN0000X 71003489 IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
RR 208
Indianapolis, IN 46202-5109

Mailing address

PO Box 1026
Indianapolis, IN 46206-1026
Phone (317) 274-1201

Other identifiers 1

IdentifierTypeStateIssuer
201087040MedicaidIN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150304001162 WV Practitioner - Nurse Practitioner 8325364623 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28193751INMDNeonatal Nurse Practitioner
71003489INMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Feb 1, 2015 Accepting new patients
Wheeling Hospital Inc CurrentSince Apr 1, 2022 Accepting new patients
University Healthcare Physicians, Inc. CurrentSince Apr 2, 2019 Accepting new patients
Wheeling Hospital Inc CurrentSince Apr 1, 2022 Accepting new patients
West Virginia University Medical Corporation Current Accepting new patients
University Healthcare Physicians Inc CurrentSince Apr 2, 2019 Accepting new patients
West Virginia University Medical Corporation CurrentSince Feb 1, 2015 Accepting new patients
University Healthcare Physicians, Inc. PastSince Nov 6, 2022 Accepting new patients
University Pediatric Associates, Inc. Past Accepting new patients

Locations

2000 Foundation Way
Ste 3100
Martinsburg, WV 25401
Phone (304) 260-1436

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

255 Scott Ave
Morgantown, WV 26508
Phone 304285710145210

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1629372651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061026",
            "telephone_number": "317-274-1201",
            "fax_number": "317-278-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "address_2": "RR 208",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-274-4715",
            "fax_number": "317-274-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "KATHLEEN",
        "middle_name": "M.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-05",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IN",
            "license": "28193751",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IN",
            "license": "71003489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201087040",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.