NPIMap

Individual provider Active NPI

Charli Ann Wheeler, APRN-CNP

  • Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1417511361
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN93573NP Issued in WV
Practice address
3100 Maccorkle Ave SE Ste 205
Charleston, WV 25304-1228
Phone
(304) 388-2303
Fax
(304) 388-2390
NPI assigned
Apr 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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 APRN93573NP WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE Ste 205
Charleston, WV 25304-1228

Mailing address

3100 Maccorkle Ave SE Ste 205
Charleston, WV 25304-1228
Phone (304) 388-2303

Other practice location 1

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Other practice location 2

3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Other practice location 3

119 Grove St
Coal Grove, OH 45638-2930
Phone (740) 547-8054

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address charli.boothe@waldenu.edu
Direct Messaging Address charli.boothe@camc.org

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
I20190626001863 WV Practitioner - Nurse Practitioner 9931433893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3100 Maccorkle Ave SE
Suite 205
Charleston, WV 25304-1228
Phone (304) 388-2303

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN93573NPWVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Jun 1, 2020 Accepting new patients
Charleston Area Medical Center, Inc. Current Accepting new patients

Locations

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

3200 Maccorkle Ave SE
#C
Charleston, WV 25304
Phone (304) 347-1336

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

3100 Maccorkle Ave SE
Ste 700
Charleston, WV 25304
Phone (304) 351-1500

3100 Maccorkle Ave SE
Ste 205
Charleston, WV 25304
Phone (304) 388-2303

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 11

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": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1417511361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 205",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041228",
            "telephone_number": "304-388-2303",
            "fax_number": "304-388-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 205",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041228",
            "telephone_number": "304-388-2303",
            "fax_number": "304-388-2390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041227",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Grove St",
            "address_purpose": "LOCATION",
            "city": "Coal Grove",
            "state": "OH",
            "postal_code": "456382930",
            "country_code": "US",
            "telephone_number": "740-547-8054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "CHARLI",
        "middle_name": "ANN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "APRN93573NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charli.boothe@waldenu.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "119 Grove St",
            "city": "Coal Grove",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456382930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charli.boothe@camc.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "3200 MacCorkle Ave SE",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253041227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.