NPIMap

Individual provider Active NPI

Vickie Lynn Powell, FNP-BC

  • Family Nurse Practitioner
  • Danville, WV
National Provider Identifier
1669721601
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN33025 Issued in WV
Practice address
462 Kenmore Dr
Danville, WV 25053-7133
Phone
(304) 369-0966
NPI assigned
Sep 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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 APRN33025 WV Primary

Addresses

Primary practice location

462 Kenmore Dr
Danville, WV 25053-7133

Mailing address

PO Box 280
Cabin Creek, WV 25035-0280
Phone (304) 344-1623

Other practice location 1

240 Capitol St Ste 500
Charleston, WV 25301-2297
Phone (304) 390-5709

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
I20130124000453 WV Practitioner - Nurse Practitioner 4688828783 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifetree Medical Services LLCGroup PAC ID 8426314667, 5 clinicians

Practice addresses (Care Compare)

462 Kenmore Dr
Danville, WV 25053-7133
Phone (304) 369-0986

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN33025WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stonerise Services, LLC Family CurrentSince Nov 13, 2023 Accepting new patients
PA Post Acute Services PC CurrentSince May 11, 2024 Accepting new patients
Lifetree Medical Services, LLC CurrentSince Dec 11, 2017 Accepting new patients
WV CHS Pharmacy Services, LLC PastSince Feb 6, 2022 Accepting new patients
Geps Physician Group of West Virginia PC Past Accepting new patients

Locations

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

240 Capitol St
Ste 500
Charleston, WV 25301
Phone (304) 344-1623

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

462 Kenmore Dr
Danville, WV 25053
Phone (304) 369-0986

859 Days Dr
Sutton, WV 26601
Phone (304) 765-2861

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 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": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1669721601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "CABIN CREEK",
            "state": "WV",
            "postal_code": "250350280",
            "telephone_number": "304-344-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 KENMORE DR",
            "city": "DANVILLE",
            "state": "WV",
            "postal_code": "250537133",
            "telephone_number": "304-369-0966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Capitol St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253012297",
            "country_code": "US",
            "telephone_number": "304-390-5709",
            "fax_number": "304-743-1994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "VICKIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN33025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, WV

Sources for this page

Verify at the official NPI Registry.