Individual provider Active NPI

Kelly Painter, NP

  • Family Nurse Practitioner
  • Gallipolis, OH
National Provider Identifier
1699219469
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.020324 Issued in OH
Practice address
100 Jackson Pike
Gallipolis, OH 45631-1560
Phone
(304) 429-1088
NPI assigned
Dec 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.020324 OH Primary
Hospitalist Physician 208M00000X CNP020324 OH

Addresses

Primary practice location

100 Jackson Pike
Gallipolis, OH 45631-1560

Mailing address

PO Box 390
Huntington, WV 25708-0390

Other practice location 1

55 Hospital Dr
Athens, OH 45701-2302
Phone (740) 592-9349

Other identifiers 2

IdentifierTypeStateIssuer
1699219469MedicaidWV
0203490MedicaidOH

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
I20170308001678 OH Practitioner - Nurse Practitioner 2264716380 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

500 Burlington Rd
Jackson, OH 45640-9360
Phone (740) 395-8420

Hospital & facility affiliations

  • Holzer Medical Center Hospital, Gallipolis, OH, CCN 360054
  • Holzer Medical Center Jackson Hospital, Jackson, OH, CCN 361320
  • St Marys Medical Center Hospital, Huntington, WV, CCN 510007
  • Holzer Medical Center Inpatient rehabilitation facility, Gallipolis, OH, CCN 36T054

Merit-based Incentive Payment System (MIPS)

Final score
84.27 of 100Reported as group
Quality
68.56
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP020324OHMDHospitalist Physician
APRN.CNP.020324OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holzer Clinic, LLC CurrentSince Jan 30, 2017 Accepting new patients
Ohio Valley Physicians Inc Family CurrentSince Jul 1, 2020 Accepting new patients
Ohio Valley Physicians Inc CurrentSince Jul 1, 2020 Accepting new patients
I Path LLC Current Accepting new patients
Hospital Development Co Past Accepting new patients

Locations

55 Hospital Dr
Ste 1
Athens, OH 45701

55 Hospital Dr
Athens, OH 45701
Phone (740) 592-9349

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

936 State Route 160
Gallipolis, OH 45631
Phone (740) 446-4600

500 Burlington Rd
Jackson, OH 45640
Phone (740) 288-4625

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 4

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": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1699219469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257080390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "304-429-1088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012302",
            "country_code": "US",
            "telephone_number": "740-592-9349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAINTER",
        "first_name": "KELLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.020324",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "CNP020324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699219469",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203490",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.