Kelly Raphael Nelson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15120 Issued in WV

Practice address

120 Medical Park Dr
Suite 300
Bridgeport, WV 26330-9012

Phone

(304) 624-7200

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Alabama School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

United Physicians Care IncGroup PAC ID 6103814017, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wvuhs Home Care Home health agency, Clarksburg, WV, CCN 517053
• Care Partners Home Health Home health agency, Westover, WV, CCN 517100
• Adoration Home Health Home health agency, Morgantown, WV, CCN 517122
• United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006
• West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001
• Mon Health Medical Center Hospital, Morgantown, WV, CCN 510024
• St Joseph'S Hospital of Buckhannon, Inc Hospital, Buckhannon, WV, CCN 511321

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

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

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: knelson106916@direct.wvuhsdirect.com

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.

• United Physicians Care Inc

  • Family Medicine Physician
  • Shinnston, WV
  • NPI 1184849200
  Medicare reassignment Care Compare group NPD
• United Hospital Center, Inc.

  • Internal Medicine Physician
  • Bridgeport, WV
  • NPI 1760965586

  Family Medicine

  Medicare reassignment NPD
• United Hospital Center

  • Surgery Physician
  • Bridgeport, WV
  • NPI 1366759227
  NPD
• United Physicians Care Inc

  • Family Medicine Physician
  • Grafton, WV
  • NPI 1891863874
  NPD
• Medexpress Urgent Care PLLC-Morgantown

  • Urgent Care Clinic/Center
  • Morgantown, WV
  • NPI 1235138280
  NPD (past)

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

• West Virginia Homecare, LLC

  • Home Health Agency
  • Westover, WV
  • NPI 1497907281
  Care Compare affiliation Name & address match
• Monongalia County General Hospital Company

  • Specialist
  • Morgantown, WV
  • NPI 1447673223

  Hospital

  Care Compare affiliation
• Monongalia County General Hospital Company

  • General Acute Care Hospital
  • Morgantown, WV
  • NPI 1659489631
  Care Compare affiliation
• St Josephs Hospital of Buckhannon Inc

  • Critical Access Hospital
  • Buckhannon, WV
  • NPI 1124005061
  Care Compare affiliation
• Tender Loving Care Health Care Services of West Virginia, LLC

  • Home Health Agency
  • Morgantown, WV
  • NPI 1215976592
  Care Compare affiliation
• United Hospital Center, Inc

  • General Acute Care Hospital
  • Bridgeport, WV
  • NPI 1184606600
  Care Compare affiliation
• West Virginia University Hospitals, Inc

  • General Acute Care Hospital
  • Morgantown, WV
  • NPI 1841271459
  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1760435838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MEDICAL PARK DR",
            "address_2": "STE 300",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309012",
            "telephone_number": "304-624-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEDICAL PARK DR",
            "address_2": "SUITE 300",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309012",
            "telephone_number": "304-624-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KELLY",
        "middle_name": "RAPHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "15120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0041162000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knelson106916@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "120 Medical Park Dr Ste 300",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263309013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knelson106916@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "120 Medical Park Dr Ste 300",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263309013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nardelli Audiology LLC
• Mazen Nashed, M.D.
• Shiv U Navada, MD
• Jessica Neidhardt, M.D.
• Ryan Michael Neil, DDS
• William Ortan Nelson, PA-C
• Alyssa Nesler, CCC-SLP
• Ashley Marie Nestor, PA-C
• Jason Clark Nestor
• Amanda Nicole Newlon

• Family Medicine Physician in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.