JUSTIN KIEL MEDLIN (NPI# 1538437629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538437629 |
| Entity Type | Individual |
| Full Name | JUSTIN KIEL MEDLIN |
| Credential | PA-C |
| Practice Address |
610 Chestnut St South Charleston WV 25309-1251 |
| Practice Telephone | 3047667515 |
| Practice Fax Number | 3047667566 |
| Mailing Telephone | 3047667515 |
| Mailing Fax Number | 3047667566 |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2017-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
577 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810006919 | 05 |
| Street Address |
610 CHESTNUT ST |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508868043 | David Leon Soulsby | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309-1251 | 2005-08-15 |
| 1316579949 | Mary Rose Butcher | Physician Assistant | 610 Chestnut St, South Charleston, WV 25309-1251 | 2020-02-11 |
| 1942565239 | Seth Thomas Craft | Podiatrist | 610 Chestnut St, South Charleston, WV 25309-1251 | 2012-07-12 |
| 1104145135 | Freddie Dominick Persinger | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309 | 2010-06-01 |
| 1649412578 | Matthew David Stover | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309-1251 | 2009-03-24 |
| 1902968548 | Orthoclinic | Durable Medical Equipment & Medical Supplies | 610 Chestnut St, South Charleston, WV 25309-1251 | 2006-12-13 |
| 1063581833 | Bruce Fredric Haupt | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309 | 2006-11-07 |
| 1114000825 | Orthoclinic | Specialist | 610 Chestnut St, South Charleston, WV 25309-1251 | 2006-10-24 |
| 1336116003 | Gary Lynn Johnson | Physician Assistant | 610 Chestnut St, South Charleston, WV 25309-1251 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750709226 | Timothy Ford | Physician Assistant | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 | 2014-04-02 |
| 1467876623 | John Wright | Physician Assistant | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 | 2014-02-09 |
| 1013331271 | Geno Anthony Santangelo Jr. | Physician Assistant | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 | 2014-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649561408 | Trell Marie Stowell | Physician Assistant | 1 Medical Center Drive, Suite 9238, Wvu Dept. of Surgery, Morgantown, WV 26506 | 2011-04-28 |
| 1821158536 | Brook E Morgan | Physician Assistant | 1600 Murdoch Avenue, Suite 100, Parkersburg, WV 26101 | 2006-12-11 |
| 1205842713 | Melissa M Glauser | Physician Assistant | 1021 Mt Dechantel Road, Wheeling, WV 26003 | 2006-08-01 |
| 1104823830 | Michael Lee Belcher | Physician Assistant | 230 George St, Suite 2, Beckley, WV 25801-2620 | 2005-07-07 |
| 1871145623 | Anthony Paul Brunetti | Physician Assistant | 215 Brookshire Ln, Beckley, WV 25801-6729 | 2019-07-11 |
| 1346733086 | Kari Rae Hunter | Physician Assistant | 210 Brooks St Ste 200, Charleston, WV 25301-1848 | 2018-06-07 |
| 1275035685 | Holly Harris | Physician Assistant | 1 Medical Center Dr, Morgantown, WV 26506-1200 | 2018-03-01 |
| 1255846671 | James Keith Burress Jr. | Physician Assistant | 2000 Eoff St, Wheeling, WV 26003-3823 | 2017-12-07 |
| 1346751237 | Adam Nathaniel Hill | Physician Assistant | 415 Morris St Ste 400, Charleston, WV 25301-1854 | 2017-10-18 |
| 1952810046 | Nathan Merl Musser | Physician Assistant | 1 Medical Park, Wheeling, WV 26003-6379 | 2017-09-21 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
Please comment or provide details below to improve the information on JUSTIN KIEL MEDLIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.