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DR. NICOLE LIA WHATLEY M.D.
NPI 1073956553
Surgery in Beckley, WV

Active since April 15, 2013PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
2962 ROBERT C BYRD DR, BECKLEY, WV 25801(681) 207-7563(304) 207-7559 Get Directions Write a Review

NPPES record last updated: June 17, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 17, 2020, Feb 12, 2020 (2 updates tracked since 2020).

About Dr. Nicole Lia Whatley M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE LIA WHATLEY M.D. (NPI 1073956553) is an individual surgery provider in Beckley, West Virginia, licensed in West Virginia (29392) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS, is affiliated with Berkeley Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1073956553
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameDR. NICOLE LIA WHATLEYCredential: M.D.
Location Address2962 ROBERT C BYRD DRBeckley, WV 25801-4448
Mailing Address2962 Robert C Byrd DrBeckley, WV 25801-4448 · (681) 207-7563 · Fax (681) 207-7559
Phone(681) 207-7563
Fax(304) 207-7559
Sole ProprietorNo
Medical School CMSEastern Virginia Medical SchoolGraduated 2013
Enumeration DateApril 15, 2013
Last NPPES UpdateJune 17, 20202 updates tracked since enumeration
NPPES CertifiedJune 17, 2020
✔ NPI 1073956553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in WV · 29392
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
2962 ROBERT C BYRD DR, Beckley, WV 25801
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Secondary Practice Locations 2

Location 11710 Harper RdBeckley, WV 25801-3357 · Phone (304) 256-4100 · Fax (304) 254-3016
Location 21717 Harper Rd Fl 2Beckley, WV 25801-3373 · Phone (681) 207-7559

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nicole Lia Whatley M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335389469
PECOS Enrollment IDI20191212000235
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Nicole Whatley reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Raleigh General Hospital LLC
0.5 mi
Cardiovascular Disease
1717 HARPER RD, SECOND FLOOR SUITE C
Beckley, WV 25801
  • Reassigned Medicare billing, West Virginia enrollment
  • 61 clinicians in this Medicare group
NPI 1083858377 (304) 461-3914
West Virginia University Medical Corporation
119 mi
Clinical Medical Laboratory
527 MEDICAL PARK DR, SUITE 108
Bridgeport, WV 26330
  • Reassigned Medicare billing, West Virginia enrollment
  • 2,471 clinicians in this Medicare group
NPI 1457605404 (304) 848-2152
City Hospital, Inc.
209 mi
Internal Medicine
207 E 5TH AVE
Ranson, WV 25438
  • Reassigned Medicare billing, West Virginia enrollment
  • 231 clinicians in this Medicare group
NPI 1336657493 (304) 725-6777

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
45 services45 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
36 services36 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
34 services15 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
28 services28 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
13 services13 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510008
Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County
Emergency services Birthing friendly

Jefferson Medical Center

Critical Access Hospitals · Ranson, WV
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number511319
Location300 South Preston StreetRanson, WV 25438 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25801 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISA G. WALKER FNP-BC
Nurse Practitioner
2962 ROBERT C BYRD DR
BECKLEY, WV 25801
Raleigh County (304) 253-6227

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Whatley's NPI number?

The NPI number for Nicole Whatley is 1073956553. It was assigned to this individual provider in the NPPES registry on April 15, 2013.

Where is Nicole Whatley located?

Nicole Whatley practices at 2962 Robert C Byrd Dr, Beckley, WV 25801. The listed phone number is (681) 207-7563.

What is Nicole Whatley's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Nicole Whatley enrolled in Medicare?

Yes. Nicole Whatley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Nicole Whatley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Whatley reassigns Medicare benefits to 3 organizations: Raleigh General Hospital LLC (Beckley, WV), West Virginia University Medical Corporation (Bridgeport, WV) and City Hospital, Inc. (Ranson, WV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Whatley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicole Whatley accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Highmark Blue Cross Blue Shield West Virginia list Nicole Whatley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nicole Whatley affiliated with any hospitals?

According to CMS data, Nicole Whatley is affiliated with Berkeley Medical Center and Jefferson Medical Center.

When was this NPI record last updated?

The NPPES record for Nicole Whatley was last updated on June 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.