Jeannie Lynn Childress, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024177239 Issued in VA

Practice address

600 W Ridge Rd
Wytheville, VA 24382-1044

Phone

(276) 228-0200

NPI assigned

Feb 9, 2019

Last updated

Feb 9, 2019By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: jeannie.childress@vab.hcadirect.net

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

{
    "created_epoch": "1549670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549670400000",
    "number": "1376008730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W RIDGE RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W RIDGE RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821044",
            "telephone_number": "276-228-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "JEANNIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-09",
        "last_updated": "2019-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024177239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Renee Cassell, LPC
• Gail Satterfield Catron, LPC
• Alexa Chandler, FNP, PMHNP
• Tessa Suzanne Chaney, FNP
• Larry Edward Chapman
• Kyoung S Cho, M.D.
• Debbie D Clark, PHYSICAL THERAPIST
• Patricia Paulette Clark, OCCUPATIONAL THERAPI
• Samantha Jo Clark, BA, RBT
• Sandra Phillippi Clarke, PHARMD

• Nurse Practitioner in Wytheville, VA
• Providers in Wytheville, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.