Individual provider Active NPI

Andrew Arlie Funk, APRN-FNP BC

  • Family Nurse Practitioner
  • Petersburg, WV
National Provider Identifier
1003793845
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
123781 Issued in WV
Practice address
117 Hospital Dr
Petersburg, WV 26847-9566
Phone
(304) 257-1026
NPI assigned
Aug 20, 2025
Last updated
Sep 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 123781 WV Primary

Addresses

Primary practice location

117 Hospital Dr
Petersburg, WV 26847-9566

Mailing address

117 Hospital Dr
Petersburg, WV 26847-9566
Phone (304) 257-1026

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
I20251005000136 WV Practitioner - Nurse Practitioner 3870978562 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Potomac Valley Hospital of W VA , IncGroup PAC ID 8123917788, shared by 6 NPIs, 90 clinicians
Grant Memorial Hospital IncGroup PAC ID 4183082712, 38 clinicians

Practice addresses (Care Compare)

100 Pin Oak LN
Keyser, WV 26726-5908
Phone (304) 597-3500

117 Hospital Dr
Petersburg, WV 26847-9566
Phone (304) 257-1026

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Memorial Hospital Inc CurrentSince Sep 30, 2025 Accepting new patients
Potomac Valley Hospital of W VA , Inc Family CurrentSince Nov 18, 2025 Accepting new patients
Potomac Valley Hospital of WV, Inc. CurrentSince Nov 18, 2025 Accepting new patients
Grant Memorial Hospital Inc CurrentSince Sep 30, 2025 Accepting new patients
Potomac Valley Hospital of W VA , Inc CurrentSince Nov 18, 2025 Accepting new patients

Locations

100 Pin Oak Ln
Keyser, WV 26726
Phone (304) 597-3500

100 Pin Oak Ln
Ste 3
Keyser, WV 26726
Phone (304) 597-3790

117 Hospital Dr
Petersburg, WV 26847
Phone (304) 257-2527

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1003793845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 HOSPITAL DR",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268479566",
            "telephone_number": "304-257-1026",
            "fax_number": "304-257-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 HOSPITAL DR",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268479566",
            "telephone_number": "304-257-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "ANDREW",
        "middle_name": "ARLIE",
        "credential": "APRN-FNP BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "123781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, WV

Sources for this page

Verify at the official NPI Registry.