Individual provider Active NPI

Connie Sue Yokum, FNP

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1558180091
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
120488 Issued in WV
Practice address
700 Chappell Rd
Charleston, WV 25304-2704
Phone
(304) 644-0504
NPI assigned
Oct 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 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 120488 WV Primary

Addresses

Primary practice location

700 Chappell Rd
Charleston, WV 25304-2704

Mailing address

1712 Lavalette Ave
Elkins, WV 26241-3020
Phone (304) 614-8320

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
I20241119004686 WV Practitioner - Nurse Practitioner 7416482039 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC CurrentSince Sep 30, 2024 Accepting new patients
Stonerise Services, LLC Family CurrentSince Sep 30, 2024 Accepting new patients

Locations

183 Holbrook Rd
Buckhannon, WV 26201
Phone (304) 472-3280

700 Chappell Rd
Charleston, WV 25304
Phone (304) 343-1950

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.

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1558180091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 LAVALETTE AVE",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262413020",
            "telephone_number": "304-614-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHAPPELL RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042704",
            "telephone_number": "304-644-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOKUM",
        "first_name": "CONNIE",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "120488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.