Angela Malcomb, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

47293 Issued in WV

Practice address

804 Broad St
Summersville, WV 26651-1796

Phone

(304) 872-2090

NPI assigned

Jun 26, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Seneca Health Services Inc

  • Developmentally Disabled Services Day Training Agency
  • Maxwelton, WV
  • NPI 1518953652
  NPD
• Seneca Health Services, Inc.

  • Community/Behavioral Health Agency
  • Summersville, WV
  • NPI 1427426329
  NPD

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1194342089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 BROAD ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 BROAD ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511796",
            "telephone_number": "304-872-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOMB",
        "first_name": "ANGELA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WV",
            "license": "47293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Louise Lough
• Delores A Lucky, C-FNP
• Grace Kathryn Lucky, DDS
• Kameron Charles Lucky, DDS
• Kevin Charles Lucky, DDS
• Amy Mann
• Julie Petersen Marcinek, DO
• Marnie Moose NP, LLC (The Med Spa)
• Marsh Hearing Center, LLC
• Robert L Marsh, M.S.

• Psychiatric/Mental Health Registered Nurse in Summersville, WV
• Providers in Summersville, WV by specialty
• Psychiatric/Mental Health Registered Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.