Individual provider Active NPI

Matya Drennen, FNP-BC

  • Family Nurse Practitioner
  • West Milford, WV
National Provider Identifier
1679901243
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN78520-FNP-BC Issued in WV
Practice address
597 Liberty St
West Milford, WV 26451-6801
Phone
(304) 745-4568
Fax
(304) 326-3700
NPI assigned
Oct 17, 2013
Last updated
Aug 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 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 APRN78520-FNP-BC WV Primary

Addresses

Primary practice location

597 Liberty St
West Milford, WV 26451-6801

Mailing address

597 Liberty St
West Milford, WV 26451-6801
Phone (304) 745-4568

Other identifiers 1

IdentifierTypeStateIssuer
1679901243MedicaidWV

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
I20160429001048 WV Practitioner - Nurse Practitioner 3072812817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

597 Liberty St
West Milford, WV 26451-6801
Phone (304) 745-4568

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN78520-FNP-BCWVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia Inc CurrentSince Mar 14, 2016 Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. CurrentSince Mar 14, 2016 Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia Inc Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: matya.drennen.1@4803.direct.athenahealth.com

Organizations & group practices 49

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.

View all 49

Hospital & facility affiliations 2

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": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1679901243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 LIBERTY ST",
            "city": "WEST MILFORD",
            "state": "WV",
            "postal_code": "264516801",
            "telephone_number": "304-745-4568",
            "fax_number": "304-326-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 LIBERTY ST",
            "city": "WEST MILFORD",
            "state": "WV",
            "postal_code": "264516801",
            "telephone_number": "304-745-4568",
            "fax_number": "304-326-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRENNEN",
        "first_name": "MATYA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-17",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN78520-FNP-BC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679901243",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Milford, WV

Sources for this page

Verify at the official NPI Registry.