Individual provider Active NPI

Kimberly Rebecca Saul, FNP

  • Family Nurse Practitioner
  • South Charleston, WV
National Provider Identifier
1932710571
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
106390 Issued in WV
Practice address
4607 Maccorkle Ave SW Ste 401
South Charleston, WV 25309-1364
Phone
(304) 414-2127
Fax
(304) 414-2120
NPI assigned
Aug 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 66623 WV
Family Nurse Practitioner 363LF0000X 106390 WV Primary

Addresses

Primary practice location

4607 Maccorkle Ave SW Ste 401
South Charleston, WV 25309-1364

Mailing address

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

Other practice location 1

11924 Winfield Rd
Winfield, WV 25213-7913
Phone (304) 767-7995

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
I20201021002037 WV Practitioner - Nurse Practitioner 1951721489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

4607 Maccorkle Ave SW
Suite 401 TMH Summit Ortho
South Charleston, WV 25309-1364
Phone (304) 414-2120

Hospital & facility affiliations

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
66623WVMDRegistered Nurse
106390WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
THS Physician Partners Inc Family CurrentSince Sep 14, 2020 Accepting new patients

Locations

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

333 Laidley St
Ste 100
Charleston, WV 25301
Phone (304) 347-6680

100 Peyton Way
Ste 200
South Charleston, WV 25309
Phone (904) 638-6147

4607 Maccorkle Ave SW
Ste 401
South Charleston, WV 25309
Phone (304) 414-2120

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

11924 Winfield Rd
Winfield, WV 25213
Phone (304) 306-3060

Organizations & group practices 1

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 1

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": "1597536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1932710571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-414-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 MACCORKLE AVE SW STE 401",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091364",
            "telephone_number": "304-414-2127",
            "fax_number": "304-414-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11924 Winfield Rd",
            "address_purpose": "LOCATION",
            "city": "Winfield",
            "state": "WV",
            "postal_code": "252137913",
            "country_code": "US",
            "telephone_number": "304-767-7995",
            "fax_number": "304-767-7996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAUL",
        "first_name": "KIMBERLY",
        "middle_name": "REBECCA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-16",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "66623",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "106390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.