NPIMap

Individual provider Active NPI

Kelly Johnson, FNP-BC

  • Family Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1780083519
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
66670 Issued in WV
Practice address
1600 Medical Center Dr Ste B500
Huntington, WV 25701-3655
Phone
(304) 691-1787
NPI assigned
Aug 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 66670 WV Primary

Addresses

Primary practice location

1600 Medical Center Dr Ste B500
Huntington, WV 25701-3655

Mailing address

1600 Medical Center Dr Ste B500
Huntington, WV 25701-3655
Phone (304) 691-1787

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelly.johnson@marshall.cernerdirect.com

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
I20150127001568 WV Practitioner - Nurse Practitioner 6608190483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
JC Edwards School of Medicine, Marshall University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3948 Teays Valley Rd
Hurricane, WV 25526-8728

400 Association Dr
Suite 102
Charleston, WV 25311-1298

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince May 23, 2023 Accepting new patients
Charleston Area Medical Center Inc CurrentSince May 23, 2023 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

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

415 Morris St
Ste 300
Charleston, WV 25301
Phone (304) 345-6303

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.

Hospital & facility affiliations 12

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": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1780083519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR STE B500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013655",
            "telephone_number": "304-691-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR STE B500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013655",
            "telephone_number": "304-691-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "66670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly.johnson@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Dr Ste B500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.