Individual provider Active NPI

Amy R Coffman, FNP-BC

  • Family Nurse Practitioner
  • Buckhannon, WV
National Provider Identifier
1386759686
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
54362 Issued in WV
Practice address
21 Auction LN
Buckhannon, WV 26201-8968
Phone
(304) 472-6041
Fax
(304) 472-4371
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 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 54362 WV Primary

Addresses

Primary practice location

21 Auction LN
Buckhannon, WV 26201-8968

Mailing address

1 Amalia Dr
Buckhannon, WV 26201-2239
Phone (304) 473-2000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address acoffman30675@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address acoffman30675@direct.wvuhsdirect.com Health Information Exchange (HIE)

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
I20060103000150 WV Practitioner - Nurse Practitioner 1557383734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph'S Hospital of Buckhannon IncGroup PAC ID 6709828163, 98 clinicians

Practice addresses (Care Compare)

21 Auction LN
Buckhannon, WV 26201-8968
Phone (304) 472-6041

Hospital & facility affiliations

  • Wvuhs Home Care Home health agency, Clarksburg, WV, CCN 517053
  • St Joseph'S Hospital of Buckhannon, Inc Hospital, Buckhannon, WV, CCN 511321
  • United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54362WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital of Buckhannon Inc CurrentSince Oct 25, 2016 Accepting new patients
St Josephs Hospital of Buckhannon Past Accepting new patients

Locations

1 Amalia Dr
Buckhannon, WV 26201
Phone (304) 473-2000

21 Auction Ln
Ste A
Buckhannon, WV 26201
Phone (304) 472-6041

21 Auction Ln
Buckhannon, WV 26201
Phone (304) 472-0245

Organizations & group practices 2

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 2

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1386759686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AMALIA DR",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012239",
            "telephone_number": "304-473-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 AUCTION LN",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262018968",
            "telephone_number": "304-472-6041",
            "fax_number": "304-472-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "AMY",
        "middle_name": "R",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "54362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acoffman30675@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln Ste A",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acoffman30675@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buckhannon, WV

Sources for this page

Verify at the official NPI Registry.