NPIMap

Individual provider Active NPI

Kellie Anne Hansel, PA-C

  • Medical Physician Assistant
  • South Charleston, WV
National Provider Identifier
1952371320
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1080 Issued in WV
Practice address
4610 Kanawha Ave SW Ste 200
South Charleston, WV 25309-1367
Phone
(304) 388-1724
Fax
(304) 205-7739
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1080 WV
Medical Physician Assistant 363AM0700X 1080 WV Primary

Addresses

Primary practice location

4610 Kanawha Ave SW Ste 200
South Charleston, WV 25309-1367

Mailing address

4610 Kanawha Ave SW Ste 200
South Charleston, WV 25309-1367
Phone (304) 388-1724

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
I20051212000777 WV Practitioner - Physician Assistant 8022039593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1836 Harper Rd
Beckley, WV 25801-3366
Phone (304) 250-0200

1838 Harper Rd
Beckley, WV 25801-3366
Phone (304) 388-9337

1844 Harper Rd
Beckley, WV 25801-3366

3100 Maccorkle Ave SE
Charleston, WV 25304-1222

4610 Maccorkle Ave SW
Suite 301
South Charleston, WV 25309-1312
Phone (304) 720-8701

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
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Feb 5, 2024 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Feb 5, 2024 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

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

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

4610 Kanawha Ave SW
Ste 200
South Charleston, WV 25309
Phone (304) 205-7992

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1952371320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 KANAWHA AVE SW STE 200",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091367",
            "telephone_number": "304-388-1724",
            "fax_number": "304-205-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 KANAWHA AVE SW STE 200",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091367",
            "telephone_number": "304-388-1724",
            "fax_number": "304-205-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEL",
        "first_name": "KELLIE",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1080",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "1080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.