NPIMap

Individual provider Active NPI

Holly Renee McKneely, FNP-BC

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1588948962
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
56057 Issued in WV
Practice address
3100 Maccorkle Ave SE
Suite 411
Charleston, WV 25304-1223
Phone
(304) 343-4400
NPI assigned
Oct 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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 56057 WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE
Suite 411
Charleston, WV 25304-1223

Mailing address

102 Lee St
Poca, WV 25159-9721
Phone (304) 776-2660

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
I20120103000782 WV Practitioner - Nurse Practitioner 0547436156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology and Headache Clinic PLLCGroup PAC ID 4688715451, 4 clinicians

Practice addresses (Care Compare)

3100 Maccorkle Ave SE
Suite 411
Charleston, WV 25304-1230
Phone (304) 343-4400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology & Headache Clinic PLLC CurrentSince Dec 20, 2011 Accepting new patients

Locations

3100 Maccorkle Ave SE
Ste 411
Charleston, WV 25304
Phone (304) 343-4400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEFFAA

Organizations & group practices 1

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": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1588948962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 LEE ST",
            "city": "POCA",
            "state": "WV",
            "postal_code": "251599721",
            "telephone_number": "304-776-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "SUITE 411",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-343-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNEELY",
        "first_name": "HOLLY",
        "middle_name": "RENEE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "56057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.