NPIMap

Individual provider Active NPI

Kevin L Eggleston, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • South Charleston, WV
National Provider Identifier
1720200744
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
21056 Issued in WV
Practice address
4619 Kanawha Ave., SW
South Charleston, WV 25309
Phone
(304) 400-4545
Fax
(304) 400-4546
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 21056 WV
Sleep Medicine (Internal Medicine) Physician 207RS0012X 21056 WV
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0200X 21056 WV Primary

Addresses

Primary practice location

4619 Kanawha Ave., SW
South Charleston, WV 25309

Mailing address

4619 Kanawha Ave., SW
South Charleston, WV 25309
Phone (304) 400-4545

Other practice location 1

4605 MacCorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 766-3583

Other practice location 2

3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Other practice location 3

200 Hospital Dr
Spencer, WV 25276-1050
Phone (304) 927-6822

Other identifiers 2

IdentifierTypeStateIssuer
7617007MedicaidNC
3810009299MedicaidWV

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
I20070727000044 WV Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7113028648 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
West Virginia University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton Community Hospital Assn. Inc.Group PAC ID 3678482221, 174 clinicians
Hospital Development Co.Group PAC ID 4183527476, 65 clinicians
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

122 12TH St
Princeton, WV 24740-2312
Phone (304) 487-7936

200 Hospital Dr
Spencer, WV 25276-1050
Phone (304) 927-4444

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

4619 Kanawha Ave SW
South Charleston, WV 25309-1319
Phone (304) 400-4545

Hospital & facility affiliations

  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029
  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046
  • Jackson General Hospital Hospital, Ripley, WV, CCN 511320
  • Roane General Hospital Hospital, Spencer, WV, CCN 511306

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21056WVMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Associates of Char LLC Single Specialty CurrentSince Aug 1, 2007 Accepting new patients
Princeton Community Hospital Assn., Inc CurrentSince Jul 7, 2024 Accepting new patients
Hospital Development Co CurrentSince Oct 1, 2020 Accepting new patients
Charleston Area Medical Center Inc Single Specialty CurrentSince Aug 1, 2007 Accepting new patients
Hospital Development Co Single Specialty Current Accepting new patients
Princeton Community Hospital Assn Inc. Single Specialty CurrentSince Jul 7, 2024 Accepting new patients
Hospital Development Co CurrentSince Dec 31, 2025 Accepting new patients
Hospital Development Co Current Accepting new patients
THS Physician Partners Inc Single Specialty CurrentSince Jun 1, 2023 Accepting new patients
Charleston Area Medical Center, Inc. Single Specialty Current Accepting new patients
Hospital Development Co Single Specialty CurrentSince Oct 1, 2020 Accepting new patients
Herbert J. Thomas Memorial Hospital Association Single Specialty Past Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

122 12th St
Princeton, WV 24740
Phone (304) 487-7061

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

4619 Kanawha Ave SW
South Charleston, WV 25309
Phone (304) 400-4545

200 Hospital Dr
Spencer, WV 25276
Phone (304) 927-4444

Interoperability endpoints

  • Direct secure messaging: keggleston@pac.gwaydirect.com
  • Direct secure messaging: keggleston358745@direct.wvuhsdirect.com

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1720200744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 KANAWHA AVE., SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25309",
            "telephone_number": "304-400-4545",
            "fax_number": "304-400-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 KANAWHA AVE., SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25309",
            "telephone_number": "304-400-4545",
            "fax_number": "304-400-4546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4605 MacCorkle Ave SW",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253091311",
            "country_code": "US",
            "telephone_number": "304-766-3583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041227",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Spencer",
            "state": "WV",
            "postal_code": "252761050",
            "country_code": "US",
            "telephone_number": "304-927-6822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGGLESTON",
        "first_name": "KEVIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2021-03-16",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WV",
            "license": "21056",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WV",
            "license": "21056",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WV",
            "license": "21056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7617007",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009299",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.