MONICA GENE HIGGINBOTHAM FNP-C
NPI 1386121374
Nurse Practitioner in South Charleston, WV

Active since July 23, 2018PECOS EnrolledAccepts Medicare Assignment
90.11/100
CMS Quality Rating
4610 KANAWHA AVE SW STE 200, SOUTH CHARLESTON, WV 25309(304) 205-7992(304) 205-7739 Get Directions Write a Review

NPPES record last updated: November 10, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 10, 2021, Jul 23, 2018 (2 updates tracked since 2018).

About Monica Gene Higginbotham Fnp-c NPPES

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

MONICA GENE HIGGINBOTHAM FNP-C (NPI 1386121374) is an individual nurse practitioner in South Charleston, West Virginia, licensed in West Virginia (APRN70740NP) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS, is affiliated with Charleston Area Medical Center, and maintains a secondary practice location in Charleston.

NPPES Registry Identity

NPI1386121374
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMONICA GENE HIGGINBOTHAMCredential: FNP-C
Location Address4610 KANAWHA AVE SW STE 200South Charleston, WV 25309-1367
Mailing Address1532 Bridge Rd Apt FCharleston, WV 25314-1900 · (304) 382-7662
Fax(304) 205-7739
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJuly 23, 2018
Last NPPES UpdateNovember 10, 20212 updates tracked since enumeration
NPPES CertifiedNovember 10, 2021
NPI 1386121374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in WV · APRN70740NP
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
4610 KANAWHA AVE SW STE 200, South Charleston, WV 25309

Secondary Practice Location 1

Location 13100 MacCorkle Ave SE Ste 101Charleston, WV 25304-1215

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Monica Gene Higginbotham Fnp-c 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 ID9133471162
PECOS Enrollment IDI20181002003392
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.

Areas of Expertise CMS Part B claims 2

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
191 services137 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.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Charleston Area Medical Center

Acute Care Hospitals · Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510022
Location501 Morris StreetCharleston, WV 25301 · Kanawha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25309 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
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
Most-billed visit code 99214
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.

90.11/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality66.96
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 8

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

Internal Medicine (Cardiovascular Disease)
4610 KANAWHA AVE SW STE 200
SOUTH CHARLESTON, WV 25309
Physician Assistant
4610 KANAWHA AVE SW STE 200
SOUTH CHARLESTON, WV 25309
Physician Assistant (Medical)
4610 KANAWHA AVE SW STE 200
SOUTH CHARLESTON, WV 25309
Physician Assistant
4610 KANAWHA AVE SW STE 200
SOUTH CHARLESTON, WV 25309
Internal Medicine (Interventional Cardiology)
4610 KANAWHA AVE SW STE 200
SOUTH CHARLESTON, WV 25309
Nurse Practitioner (Family)
4610 KANAWHA AVE SW STE 200
SOUTH CHARLESTON, WV 25309
Physician Assistant (Medical)
4610 KANAWHA AVE SW STE 200
SOUTH CHARLESTON, WV 25309
Physician Assistant (Medical)
4610 KANAWHA AVE SW STE 200
CHARLESTON, WV 25309

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 Monica Higginbotham's NPI number?

The NPI number for Monica Higginbotham is 1386121374. It was assigned to this individual provider in the NPPES registry on July 23, 2018.

Where is Monica Higginbotham located?

Monica Higginbotham practices at 4610 Kanawha Ave SW Ste 200, South Charleston, WV 25309. The listed phone number is (304) 205-7992.

What is Monica Higginbotham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Monica Higginbotham enrolled in Medicare?

Yes. Monica Higginbotham 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.

What insurance does Monica Higginbotham accept?

Health plans from CareSource list Monica Higginbotham 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 Monica Higginbotham affiliated with any hospitals?

According to CMS data, Monica Higginbotham is affiliated with Charleston Area Medical Center.

When was this NPI record last updated?

The NPPES record for Monica Higginbotham was last updated on November 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.