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Individual provider Active NPI

Crystal Gail Sheaves, FNP

  • Family Nurse Practitioner
  • Ronceverte, WV
National Provider Identifier
1811980378
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53104 Issued in WV
Practice address
9109 Seneca TRL S
Ronceverte, WV 24970-1791
Phone
(304) 645-1787
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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 53104 WV Primary

Addresses

Primary practice location

9109 Seneca TRL S
Ronceverte, WV 24970-1791

Mailing address

9109 Seneca TRL S
Ronceverte, WV 24970-1791
Phone (304) 645-1787

Other identifiers 1

IdentifierTypeStateIssuer
7103195000MedicaidWV

Other names 1

  • Crystal Gail McKinney 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
I20031230000343 WV Practitioner - Nurse Practitioner 1951209840 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenbrier County Board of HealthGroup PAC ID 9032293378, 2 clinicians

Practice addresses (Care Compare)

9109 Seneca TRL S
Ronceverte, WV 24970-1791
Phone (304) 645-1787

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rainelle Medical Center, Inc. CurrentSince Apr 1, 2016 Accepting new patients
Greenbrier County Board of Health CurrentSince Aug 3, 2014 Accepting new patients
Rainelle Medical Center Inc CurrentSince Apr 1, 2016 Accepting new patients
Rainelle Medical Center Inc Current Accepting new patients
BJSM Med Inc Past Accepting new patients
New River Health Association, Inc. Past Accepting new patients
Greenbrier Valley Emergency Physicians LLC Past Accepting new patients

Locations

101 Railroad St
Alderson, WV 24910
Phone (304) 438-6818

176 Medical Center Dr
Rainelle, WV 25962

205 Medical Center Dr
Rainelle, WV 25962
Phone (304) 438-1922

9109 Seneca Trl S
Ronceverte, WV 24970
Phone (304) 645-1787

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arh Family Care - WaylandWayland, KY, CCN 188537 Rural health clinic Corporate Director Feb 21, 2020
Arh McDowell ClinicMC Dowell, KY, CCN 188538 Rural health clinic Corporate Director Feb 21, 2020
Arh Medical and Specialty Associates - PrestonburgPrestonsburg, KY, CCN 188539 Rural health clinic Corporate Director Feb 21, 2020
Arh Medical and Specialty Associates - HazardHazard, KY, CCN 188542 Rural health clinic Corporate Director Feb 21, 2020
Arh Medical Mall Family Specialty ClinicHazard, KY, CCN 188543 Rural health clinic Corporate Director Feb 21, 2020

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1811980378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9109 SENECA TRL S",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249701791",
            "telephone_number": "304-645-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 SENECA TRL S",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249701791",
            "telephone_number": "304-645-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAVES",
        "first_name": "CRYSTAL",
        "middle_name": "GAIL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "53104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7103195000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "MCKINNEY",
            "middle_name": "GAIL",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ronceverte, WV

Sources for this page

Verify at the official NPI Registry.