Amaris Medical, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

AMARIS MEDICAL, LLC

Practice address

76 Lewis Street
Whitesville, WV 25209

Phone

(304) 896-0268

Fax

(304) 896-0289

NPI assigned

Sep 24, 2020

Organization subpart

No

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

Authorized official

Name

Angel L Stover, APRN

Title

Owner

Phone

(681) 207-7007

Specialties & licenses 3

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandy Cook

  • Social Worker
  • Beckley, WV
  • NPI 1184185977
  NPD

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1013524057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "WHITESVILLE",
            "state": "WV",
            "postal_code": "252090130",
            "telephone_number": "304-896-0268",
            "fax_number": "304-896-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 LEWIS STREET",
            "city": "WHITESVILLE",
            "state": "WV",
            "postal_code": "25209",
            "telephone_number": "304-896-0268",
            "fax_number": "304-896-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARIS MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "STOVER",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "681-207-7007",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV SECRETARY OF STATE",
            "identifier": "499198",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Venkata Amaravadi, PHARMACIST
• Gloria Mae Barker
• Tia Joan Clay
• Angel Grace Conklin
• Katherine Eva Conklin
• Brandon Noel Daniel, PHARMD

• Nurse Practitioner in Whitesville, WV
• Providers in Whitesville, WV by specialty
• Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.