Individual provider Active NPI

Rebecca Ann Fraley, MSN-FNP-BC

  • Family Nurse Practitioner
  • Barboursville, WV
National Provider Identifier
1346999695
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110263 Issued in WV
Practice address
912 Rivers Edge
Barboursville, WV 25504-9508
Phone
(304) 306-3058
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 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 110263 WV Primary

Addresses

Primary practice location

912 Rivers Edge
Barboursville, WV 25504-9508

Mailing address

912 Rivers Edge
Barboursville, WV 25504-9508

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
I20220407000506 WV Practitioner - Nurse Practitioner 9638565203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2827 5TH Ave
Huntington, WV 25702-1435
Phone (304) 399-7182

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110263WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Medical Management, LLC Current Accepting new patients
St. Mary'S Medical Management, LLC Family CurrentSince Aug 28, 2023 Accepting new patients
Occumed, LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

2827 5th Ave
Huntington, WV 25702
Phone (304) 399-7182

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

2 Stonecrest Dr
Huntington, WV 25701
Phone (304) 525-2273

Organizations & group practices 3

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1346999695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 RIVERS EDGE",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255049508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 RIVERS EDGE",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255049508",
            "telephone_number": "304-306-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "MSN-FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "110263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barboursville, WV

Sources for this page

Verify at the official NPI Registry.