Individual provider Active NPI

Ambra Baldwin Nida, FNP-BC

  • Family Nurse Practitioner
  • Buckeye, WV
National Provider Identifier
1558517060
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024167957 Issued in VA
Practice address
150 Duncan Rd
Buckeye, WV 24924-9037
Phone
(304) 799-7400
NPI assigned
Aug 15, 2008
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 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 0024167957 VA Primary

Addresses

Primary practice location

150 Duncan Rd
Buckeye, WV 24924-9037

Mailing address

102 Lakewood LN
Covington, VA 24426-5717
Phone (540) 965-1199

Other practice location 1

106 Park Dr
PO Drawer Z
Hot Springs, VA 24445-2921
Phone (540) 839-7197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 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
I20080911000524 VA Practitioner - Nurse Practitioner 4789750928
I20230505000401 WV Practitioner - Nurse Practitioner 4789750928 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
0024167957VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pocahontas Memorial Hospital CurrentSince Apr 1, 2023 Accepting new patients
Pocahontas Memorial Hospital Current Accepting new patients
Greenbrier Physicians, Inc CurrentSince Oct 1, 2021 Accepting new patients
Long Term Care of America-Virginia, Inc. Past Accepting new patients
Ronceverte Physician Group LLC Past Accepting new patients

Locations

1 Arh Ln
Ste 112
Low Moor, VA 24457
Phone (304) 647-5114

150 Duncan Rd
Buckeye, WV 24924
Phone (304) 799-7400

1322 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 647-1139

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1558517060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 LAKEWOOD LN",
            "city": "COVINGTON",
            "state": "VA",
            "postal_code": "244265717",
            "telephone_number": "540-965-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 DUNCAN RD",
            "city": "BUCKEYE",
            "state": "WV",
            "postal_code": "249249037",
            "telephone_number": "304-799-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Park Dr",
            "address_2": "PO Drawer Z",
            "address_purpose": "LOCATION",
            "city": "Hot Springs",
            "state": "VA",
            "postal_code": "244452921",
            "country_code": "US",
            "telephone_number": "540-839-7197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIDA",
        "first_name": "AMBRA",
        "middle_name": "BALDWIN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024167957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, WV

Sources for this page

Verify at the official NPI Registry.