Individual provider Active NPI

Lyndsay Megan Wickline

  • Family Nurse Practitioner
  • Parkersburg, WV
National Provider Identifier
1659901817
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
105139 Issued in WV
Practice address
3194 Core Rd
Parkersburg, WV 26104-1556
Phone
(304) 485-5185
NPI assigned
Jan 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 78677 WV
Family Nurse Practitioner 363LF0000X 105139 WV Primary

Addresses

Primary practice location

3194 Core Rd
Parkersburg, WV 26104-1556

Mailing address

3194 Core Rd
Parkersburg, WV 26104-1556
Phone (304) 485-5185

Other practice location 1

1066 Union School Rd
Leon, WV 25123-5657
Phone (304) 646-4923

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
I20200903001008 WV Practitioner - Nurse Practitioner 0840617981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3194 Core Rd
Parkersburg, WV 26104-1556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
78677WVMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Worthington Mental Health, LLC CurrentSince Aug 31, 2020 Accepting new patients

Locations

3194 Core Rd
Parkersburg, WV 26104
Phone (304) 485-5185

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": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1659901817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3194 CORE RD",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261041556",
            "telephone_number": "304-485-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3194 CORE RD",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261041556",
            "telephone_number": "304-485-5185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1066 Union School Rd",
            "address_purpose": "LOCATION",
            "city": "Leon",
            "state": "WV",
            "postal_code": "251235657",
            "country_code": "US",
            "telephone_number": "304-646-4923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKLINE",
        "first_name": "LYNDSAY",
        "middle_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "78677",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "105139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.