NPIMap

Individual provider Active NPI

Tina Louise Prince, APRN, NP-C

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1164088647
Registry record updated May 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN61702NP Issued in WV
Practice address
800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone
(304) 388-5432
NPI assigned
May 10, 2019
Last updated
May 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2022

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 APRN61702NP WV Primary

Addresses

Primary practice location

800 Pennsylvania Ave
Charleston, WV 25302-3351

Mailing address

PO Box 691
Uneeda, WV 25205-0691
Phone (304) 928-1886

Other practice location 1

20 Hospital Dr
Logan, WV 25601-3452
Phone (304) 831-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220617000367 WV Practitioner - Nurse Practitioner 2466831722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-7823

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN61702NPWVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Jul 5, 2022 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Jul 5, 2022 Accepting new patients
Appalachia Pathology Consultants LLC Current Accepting new patients
Logan General Hospital LLC CurrentSince Mar 8, 2022 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

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 12

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": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653177600000",
    "number": "1164088647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691",
            "city": "UNEEDA",
            "state": "WV",
            "postal_code": "252050691",
            "telephone_number": "304-928-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PENNSYLVANIA AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023351",
            "telephone_number": "304-388-5432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "WV",
            "postal_code": "256013452",
            "country_code": "US",
            "telephone_number": "304-831-1101",
            "fax_number": "304-831-1651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "TINA",
        "middle_name": "LOUISE",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2022-05-22",
        "certification_date": "2022-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN61702NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.