Individual provider Active NPI

Andrew Corey Colegrove, APRN

  • Family Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1497428759
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
108968 Issued in WV
Practice address
1540 Spring Valley Dr
Huntington, WV 25704-9501
Phone
(304) 429-6741
NPI assigned
Jul 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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 108968 WV Primary

Addresses

Primary practice location

1540 Spring Valley Dr
Huntington, WV 25704-9501

Mailing address

1540 Spring Valley Dr
Huntington, WV 25704-9501
Phone (044) 296-7413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260421000848 WV Practitioner - Nurse Practitioner 6608260245 Reassigns benefits to 2 organizations
I20260605003082 OH Practitioner - Nurse Practitioner 6608260245 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

4535 Dressier Rd NW
Canton, OH 44718-2545

4535 Dressler Rd NW
Canton, OH 44718-2545

53 Township Rd
Suite 282
Ironton, OH 45638

53 Township Rd
Suite 282
Ironton, OH 45638-8972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108968WVMDFamily Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1497428759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257049501",
            "telephone_number": "044-296-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257049501",
            "telephone_number": "304-429-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEGROVE",
        "first_name": "ANDREW",
        "middle_name": "COREY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-30",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "108968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.