Madeline K Staley, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024171775 Issued in VA

Practice address

3452 Anderson Hwy Ste D
Powhatan Medical Associates
Powhatan, VA 23139-5845

Phone

(804) 285-6050

Fax

(804) 598-2481

NPI assigned

Jul 31, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Madeline Rose Klim Former name

Medicare fee-for-service enrollment

Enrolled in VA

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: madeline.staley.1@8042.direct.athenahealth.com

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  Medicare reassignment Care Compare group NPD
• Minuteclinic Diagnostic of Virginia LLC

  • Family Nurse Practitioner
  • Leesburg, VA
  • NPI 1417076829
  Medicare reassignment
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Bon Secours St Francis Medical Center LLC

  • Surgery Physician
  • Midlothian, VA
  • NPI 1083841936
  NPD (past)
• Bon Secours St. Francis Medical Center Inc

  • Neurology Physician
  • Chester, VA
  • NPI 1811228711
  NPD (past)
• Bon Secours St. Francis Medical Center LLC

  • Internal Medicine Physician
  • Midlothian, VA
  • NPI 1053698399
  NPD (past)
• Nova Physician Wellness Center PLLC

  • Family Medicine Physician
  • Fairfax, VA
  • NPI 1215307400
  NPD (past)

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1194133363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3452 ANDERSON HWY",
            "address_2": "SUITE D",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231395845",
            "telephone_number": "804-285-6050",
            "fax_number": "804-598-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3452 ANDERSON HWY STE D",
            "address_2": "POWHATAN MEDICAL ASSOCIATES",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231395845",
            "telephone_number": "804-285-6050",
            "fax_number": "804-598-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "MADELINE",
        "middle_name": "K",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C09633",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "KLIM",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lesley Diane Skinner, OTR/L
• Sarah Smith, RN, CRNA, LNP
• Shelly P Smith, A.N.P.
• Ayman A Soker, PT
• Ernest Tracy Spaur, DDS
• William Harold Stewart Jr.
• Cristina Maria Story, DNP, FNP-C
• Kei Takahashi
• Martha M Talley, R.PH.
• Autumn Thompson, PHARMD

• Family Nurse Practitioner in Powhatan, VA
• Providers in Powhatan, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.