Individual provider Active NPI

Kelly Beth Hughart, NURSE PRACTITIONER

  • Nurse Practitioner
  • South Charleston, WV
National Provider Identifier
1760154413
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
110561 Issued in WV
Practice address
24 Maccorkle Ave SW
South Charleston, WV 25303-1476
Phone
(304) 720-5000
Fax
(304) 720-5003
NPI assigned
Oct 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 110561 WV Primary

Addresses

Primary practice location

24 Maccorkle Ave SW
South Charleston, WV 25303-1476

Mailing address

24 Maccorkle Ave SW
South Charleston, WV 25303-1476
Phone (304) 720-5000

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
I20211216001066 WV Practitioner - Nurse Practitioner 0446355861 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

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

State licenses

LicenseStateTypeSpecialty
110561WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Consultants, PLLC CurrentSince Oct 11, 2021 Accepting new patients
Camden-Clark Physician Corporation CurrentSince Mar 16, 2023 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

801 Garfield Ave
Ste 100
Parkersburg, WV 26101
Phone (304) 424-2170

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

24 Maccorkle Ave SW
Ste 201
South Charleston, WV 25303
Phone (304) 720-5000

24 Maccorkle Ave SW
South Charleston, WV 25303
Phone (304) 720-2222

Organizations & group practices 3

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": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1760154413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031476",
            "telephone_number": "304-720-5000",
            "fax_number": "304-720-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031476",
            "telephone_number": "304-720-5000",
            "fax_number": "304-720-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHART",
        "first_name": "KELLY",
        "middle_name": "BETH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "110561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.