NPIMap

Individual provider Active NPI

Lynnetta Faith Payne, D.O.

  • Urology Physician
  • Beckley, WV
National Provider Identifier
1366636763
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2330 Issued in WV
Practice address
1717 Harper Rd
Third Floor, Suite a&B
Beckley, WV 25801-3373
Phone
(304) 461-3879
Fax
(304) 461-0256
NPI assigned
Aug 29, 2007
Last updated
Jun 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2330 WV Primary

Addresses

Primary practice location

1717 Harper Rd
Third Floor, Suite a&B
Beckley, WV 25801-3373

Mailing address

1717 Harper Rd
Third Floor Suite a&B
Beckley, WV 25801-3373
Phone (304) 461-3879

Other identifiers 2

IdentifierTypeStateIssuer
WV1663AOtherWVMEDICARE PTAN
51D2046168OtherCLIA

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
I20120925000661 WV Practitioner - Urology 3779732391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
West Virginia School of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh General Hospital LLCGroup PAC ID 6103735154, 27 clinicians

Practice addresses (Care Compare)

1710 Harper Rd
Beckley, WV 25801-3357
Phone (304) 252-0641

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2330WVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh General Hospital LLC CurrentSince Jul 16, 2012 Accepting new patients
Raleigh General Hospital LLC Urology CurrentSince Jul 16, 2012 Accepting new patients
Raleigh General Hospital LLC Past Accepting new patients

Locations

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

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

1717 Harper Rd
Fl 3
Beckley, WV 25801
Phone (304) 254-3131

1717 Harper Rd
Fl Third
Beckley, WV 25801
Phone (304) 461-3879

1717 Harper Rd
Ste A
Beckley, WV 25801
Phone (304) 461-3879

Interoperability endpoints

  • Direct secure messaging: lynneta.payne.1@20211.direct.athenahealth.com
  • Direct secure messaging: lynnetta.payne@wvafn.hcadirect.net

Organizations & group practices 4

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1366636763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 HARPER RD",
            "address_2": "THIRD FLOOR SUITE A&B",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013373",
            "telephone_number": "304-461-3879",
            "fax_number": "304-461-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 HARPER RD",
            "address_2": "THIRD FLOOR, SUITE A&B",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013373",
            "telephone_number": "304-461-3879",
            "fax_number": "304-461-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "LYNNETTA",
        "middle_name": "FAITH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WV",
            "license": "2330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV1663A",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "51D2046168",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.