Active NPI
Christina Renee McCracken, PA-C
- Medical Physician Assistant
- Beckley, WV
National Provider Identifier
1841628419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 01110
- Practice address
- 200 Veterans Ave
Beckley, WV 25801-6444 - Phone
- (304) 255-2121
- NPI assigned
- Oct 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 01110 | WV | Primary |
Addresses
Primary practice location
200 Veterans Ave
Beckley, WV 25801-6444
Mailing address
156 Misty LN
Shady Spring, WV 25918-8467
Phone (304) 763-4129
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01110 | WV | MD | Medical Physician Assistant |
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": "1381968000000",
"number": "1841628419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 MISTY LN",
"city": "SHADY SPRING",
"state": "WV",
"postal_code": "259188467",
"telephone_number": "304-763-4129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 VETERANS AVE",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258016444",
"telephone_number": "304-255-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCRACKEN",
"first_name": "CHRISTINA",
"middle_name": "RENEE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-17",
"last_updated": "2013-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WV",
"license": "01110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.