Individual provider Active NPI

Madison Evans, FNP-BC

  • Family Nurse Practitioner
  • Petersburg, WV
National Provider Identifier
1790412880
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
124389 Issued in WV
Practice address
117 Hospital Dr
Petersburg, WV 26847-9566
Phone
(304) 257-1026
Fax
(304) 257-1412
NPI assigned
Aug 8, 2022
Last updated
Feb 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 124389 WV Primary
School Registered Nurse 163WS0200X 101666 WV

Addresses

Primary practice location

117 Hospital Dr
Petersburg, WV 26847-9566

Mailing address

PO Box 876
Morgantown, WV 26507-0876
Phone (304) 257-1026

Other practice location 1

Grant County Board of Education
204 Jefferson Avenue
Petersburg, WV 26847
Phone (304) 267-3595 ext. 138

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
I20251219003041 WV Practitioner - Nurse Practitioner 8022503762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Morgantown, WV 26507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101666WVMDSchool Registered Nurse
124389WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Memorial Hospital Inc CurrentSince Dec 9, 2025 Accepting new patients
Grant Memorial Hospital Inc CurrentSince Dec 9, 2025 Accepting new patients
Grant County Board of Education PastSince Aug 14, 2022 Accepting new patients
Grant County Board of Education PastSince Aug 14, 2022 Accepting new patients

Locations

117 Hospital Dr
Petersburg, WV 26847
Phone 30497450009312

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1790412880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 876",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070876",
            "telephone_number": "304-257-1026",
            "fax_number": "304-257-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 HOSPITAL DR",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268479566",
            "telephone_number": "304-257-1026",
            "fax_number": "304-257-1412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Grant County Board of Education",
            "address_2": "204 Jefferson Avenue",
            "address_purpose": "LOCATION",
            "city": "Petersburg",
            "state": "WV",
            "postal_code": "26847",
            "country_code": "US",
            "telephone_number": "304-267-3595 x138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MADISON",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "124389",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WV",
            "license": "101666",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, WV

Sources for this page

Verify at the official NPI Registry.