NPIMap

Individual provider Active NPI

Betsy Dawn Legg, FNP-MSN

  • School Registered Nurse
  • Nitro, WV
National Provider Identifier
1861660706
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
56058 Issued in WV
Practice address
4114 1St Ave
Nitro, WV 25143-1304
Phone
(304) 755-0119
Fax
(304) 755-0111
NPI assigned
Feb 13, 2008
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 APRN56058 WV
School Registered Nurse 163WS0200X 56058 WV Primary

Addresses

Primary practice location

4114 1St Ave
Nitro, WV 25143-1304

Mailing address

4114 1St Ave
Nitro, WV 25143-1304
Phone (304) 755-0119

Other practice location 1

114 Jamie Lane 1343
Eleanor, WV 25070
Phone (304) 550-8479

Other identifiers 1

IdentifierTypeStateIssuer
3810005642MedicaidWV

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
I20190816002087 WV Practitioner - Nurse Practitioner 8325375116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mountaineer Family Medicine, Inc.Group PAC ID 5496858102, 6 clinicians

Practice addresses (Care Compare)

5240 Maccorkle Ave SE
Charleston, WV 25304-2122
Phone (304) 926-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56058WVMDSchool Registered Nurse
APRN56058WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountaineer Family Medicine, Inc. CurrentSince Jun 12, 2019 Accepting new patients
Putnam County Schools Past Accepting new patients
Putnam County Schools Past Accepting new patients

Locations

5240 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 926-2300

4114 1st Ave
Nitro, WV 25143
Phone (304) 755-0110

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1861660706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 1ST AVE",
            "city": "NITRO",
            "state": "WV",
            "postal_code": "251431304",
            "telephone_number": "304-755-0119",
            "fax_number": "304-755-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 1ST AVE",
            "city": "NITRO",
            "state": "WV",
            "postal_code": "251431304",
            "telephone_number": "304-755-0119",
            "fax_number": "304-755-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Jamie Lane 1343",
            "address_purpose": "LOCATION",
            "city": "Eleanor",
            "state": "WV",
            "postal_code": "25070",
            "country_code": "US",
            "telephone_number": "304-550-8479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGG",
        "first_name": "BETSY",
        "middle_name": "DAWN",
        "credential": "FNP-MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN56058",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WV",
            "license": "56058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005642",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nitro, WV

Sources for this page

Verify at the official NPI Registry.