Jeniffer Rachelle Wickline, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

106770 Issued in WV

Practice address

1265 Maplewood Ave
Lewisburg, WV 24901-9478

Phone

(304) 645-2700

Fax

(304) 645-3188

NPI assigned

Oct 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kanawha Hospice Care, Inc 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Camc Greenbrier Valley Medical Center, Inc Hospital, Ronceverte, WV, CCN 510002

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• Kanawha Hospice Care, Inc

  • Community Based Hospice Care Agency
  • Charleston, WV
  • NPI 1174556641

  WV

  Medicare reassignment Care Compare group NPD
• Kanawha Hospice Care, Inc.

  • Home Health Agency
  • Charleston, WV
  • NPI 1679221956
  Care Compare group NPD

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

• Camc Greenbrier Valley Medical Center Inc

  • General Acute Care Hospital
  • Ronceverte, WV
  • NPI 1679299408

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1013517259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 MAPLEWOOD AVE",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019478",
            "telephone_number": "304-645-2700",
            "fax_number": "304-645-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 MAPLEWOOD AVE",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019478",
            "telephone_number": "304-645-2700",
            "fax_number": "304-645-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLINE",
        "first_name": "JENIFFER",
        "middle_name": "RACHELLE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "106770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher L White, DO
• Jennifer Nicole White, RN
• Laura Ann White
• Mathew William White
• Allison M Wickline
• Emily L Wiley, FNP-C
• Lisa Gail Williams
• Karla Ann Willis
• Willow Ridge PLLC
• Rebekah Wills

• All providers in Lewisburg, WV
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.