Individual provider Active NPI

Angela G McKinney, NP-C

  • Nurse Practitioner
  • Princeton, WV
National Provider Identifier
1285989152
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
51212 Issued in WV
Practice address
904 Harrison St
Princeton, WV 24740-3011
Phone
(304) 431-7100
Fax
(304) 431-7112
NPI assigned
Jul 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 51212 WV Primary

Addresses

Primary practice location

904 Harrison St
Princeton, WV 24740-3011

Mailing address

PO Box 507
RR 103 Supply Street
Gary, WV 24836-0507
Phone (304) 448-2101

Other practice location 1

RR 103 Supply Street
Gary, WV 24836-0507
Phone (304) 448-2101 ext. 242

Other identifiers 1

IdentifierTypeStateIssuer
3810023868MedicaidWV

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121001000446 WV Practitioner - Nurse Practitioner 8921257296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 Bill Baker Way
Beckley, WV 25801-1505

Hospital & facility affiliations

  • PCH Home Health Home health agency, Princeton, WV, CCN 517081
  • Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Systems, Inc. CurrentSince Feb 11, 2024 Accepting new patients
Highcountry Clinic of Alternative Healthcare PC Current Accepting new patients
Community Health Systems Inc CurrentSince Feb 11, 2024 Accepting new patients
Tug River Health Association, Inc CurrentSince Aug 5, 2012 Accepting new patients
Associates in OB GYN, Inc Past Accepting new patients

Locations

252 Rural Acres Dr
Beckley, WV 25801
Phone (304) 252-8551

Interoperability endpoints

  • Direct secure messaging: angela.mckinney.1@14333.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1285989152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 507",
            "address_2": "RR 103 SUPPLY STREET",
            "city": "GARY",
            "state": "WV",
            "postal_code": "248360507",
            "telephone_number": "304-448-2101",
            "fax_number": "304-448-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 HARRISON ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403011",
            "telephone_number": "304-431-7100",
            "fax_number": "304-431-7112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "RR 103 SUPPLY STREET",
            "address_purpose": "LOCATION",
            "city": "GARY",
            "state": "WV",
            "postal_code": "248360507",
            "country_code": "US",
            "telephone_number": "304-448-2101 x242",
            "fax_number": "304-448-3217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "ANGELA",
        "middle_name": "G",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2025-01-09",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "51212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023868",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.