Kimberley Lis Barracco, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2064 Issued in WV

Practice address

12 Kanawha Ter
Saint Albans, WV 25177-2750

Phone

(304) 757-6999

NPI assigned

Sep 20, 2006

Last updated

Sep 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7363/brand/1/csg/1/fhir/r4
• Direct secure messaging: kbarracco77946@direct-srhs.et0939.epichosted.com

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.

• Womencare Inc

  dba FamilyCare Health Center

  • Federally Qualified Health Center (FQHC)
  • Cross Lanes, WV
  • NPI 1396237434
  Medicare reassignment NPD
• Womencare Inc

  dba FamilyCare

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1790276525
  Medicare reassignment NPD
• Womencare Inc

  dba FamilyCare Health Center - Hurricane

  • Federally Qualified Health Center (FQHC)
  • Hurricane, WV
  • NPI 1962045948
  Medicare reassignment NPD
• Womencare, Inc

  dba Familycare Health Centers

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1174106124
  Medicare reassignment NPD
• Womencare, Inc

  • Federally Qualified Health Center (FQHC)
  • Madison, WV
  • NPI 1740450089
  Medicare reassignment NPD
• Women Care Inc

  dba FamilyCare Health Center

  • Federally Qualified Health Center (FQHC)
  • Scott Depot, WV
  • NPI 1194759290
  Medicare reassignment
• Womencare Inc

  dba FamilyCare HealthCenter

  • Federally Qualified Health Center (FQHC)
  • Barboursville, WV
  • NPI 1447618327
  NPD
• Womencare Inc

  dba FamilyCare

  • Federally Qualified Health Center (FQHC)
  • Winfield, WV
  • NPI 1477834216
  NPD
• Womencare Inc

  dba Familycare Health Center

  • Federally Qualified Health Center (FQHC)
  • Dunbar, WV
  • NPI 1578073706
  NPD
• Womencare Inc

  dba Familycare Health Centers

  • Federally Qualified Health Center (FQHC)
  • Marmet, WV
  • NPI 1730671751
  NPD
• Womencare Inc

  dba FamilyCare

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1770745036
  NPD
• Womencare Inc

  dba FamilyCare Health Center

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1871872184
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1700984366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293042168",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 KANAWHA TER",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772750",
            "telephone_number": "304-757-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRACCO",
        "first_name": "KIMBERLEY",
        "middle_name": "LIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "39076",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "2064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbarracco77946@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kbarracco77946@direct-srhs.et0939.epichosted.com",
            "address_1": "407 W South St",
            "city": "Union",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittany Kay Baldwin
• Vickie Baldwin
• Amy Barkley, LPC
• Amanda Barlow
• Amy Barnhart
• Jeffrey Barth
• Christal Barton
• Jesylyn Baumbush
• Judy Baxter
• Kristen Bays, PRSS

• Pediatrics Physician in Saint Albans, WV
• Providers in Saint Albans, WV by specialty
• Pediatrics Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.