NPIMap

Individual provider Active NPI

Ursula Dawn Perry

  • Family Nurse Practitioner
  • Montgomery, WV
National Provider Identifier
1750152328
Registry record updated Mar 13, 2024
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Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
118917 Issued in WV
Practice address
401 6TH Ave
Montgomery, WV 25136-2199
Phone
(304) 442-5151
Fax
(304) 442-7463
NPI assigned
Jan 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 88944 WV
Family Nurse Practitioner 363LF0000X 118917 WV Primary

Addresses

Primary practice location

401 6TH Ave
Montgomery, WV 25136-2199

Mailing address

6 Meadow Rd
Charleston, WV 25314-2200
Phone (304) 206-8810

Other names 1

  • Ursula Dawn Angel Former name

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
I20241021003490 WV Practitioner - Nurse Practitioner 8426580002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montgomery General Hospital, IncGroup PAC ID 6204735269, 37 clinicians

Practice addresses (Care Compare)

401 6TH Ave
Montgomery, WV 25136-2116
Phone (304) 442-5151

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Charleston, WV, CCN 517115
  • Montgomery General Hospital Hospital, Montgomery, WV, CCN 511318
  • 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
88944WVMDRegistered Nurse
118917WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery General Hospital, Inc CurrentSince Jul 18, 2024 Accepting new patients
Montgomery General Hospital, Inc CurrentSince Jul 18, 2024 Accepting new patients
Montgomery General Hospital, Inc. Past Accepting new patients

Locations

401 6th Ave
Montgomery, WV 25136
Phone (304) 442-5151

401 6th Ave
Ste 301
Montgomery, WV 25136
Phone (304) 442-2521

Organizations & group practices 3

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1750152328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MEADOW RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142200",
            "telephone_number": "304-206-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 6TH AVE",
            "city": "MONTGOMERY",
            "state": "WV",
            "postal_code": "251362199",
            "telephone_number": "304-442-5151",
            "fax_number": "304-442-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "URSULA",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "88944",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "118917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "URSULA",
            "last_name": "ANGEL",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montgomery, WV

Sources for this page

Verify at the official NPI Registry.