NPIMap

Individual provider Active NPI

Kimberly A Rossi, MD

  • Specialist
  • Charleston, WV
National Provider Identifier
1699875468
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
20839 Issued in WV
Practice address
3100 Maccorkle Ave
Suite201
Charleston, WV 25304-1223
Phone
(304) 342-3360
Fax
(304) 342-3363
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 20839 WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave
Suite201
Charleston, WV 25304-1223

Mailing address

2617 Virginia Avenue
Charleston, WV 25304
Phone (304) 881-2600

Other identifiers 1

IdentifierTypeStateIssuer
3810004528MedicaidWV

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
I20051026001221 WV Practitioner - Dermatology 4688690209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
West Virginia University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3100 Maccorkle Ave SE
Suite 201
Charleston, WV 25304-1228
Phone (304) 342-3360

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions983
Removal or shaving of skin growth236
Skin biopsy83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20839WVMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kar MD Specialist CurrentSince Jul 8, 2005 Accepting new patients
Lynn McKinley-Grant, MD, PC Past Accepting new patients
Dermatology Associates, P.C. PastSince Jun 28, 2017 Accepting new patients
Elizabeth Mitchell Dugan MD LLC Specialist Past Accepting new patients
Dermatology Associates of McLean PastSince Sep 17, 2001 Accepting new patients

Locations

3100 Maccorkle Ave SE
Ste 201
Charleston, WV 25304
Phone (304) 342-3360

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699875468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 VIRGINIA AVENUE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-881-2600",
            "fax_number": "304-342-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE",
            "address_2": "SUITE201",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-342-3360",
            "fax_number": "304-342-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSI",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "20839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004528",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.