NPIMap

Individual provider Active NPI

Alysia Renee Funk, FNP-BC

  • Family Nurse Practitioner
  • Bruceton Mills, WV
National Provider Identifier
1861742629
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN52464 Issued in WV
Practice address
198 Morgantown St Ste 2
Bruceton Mills, WV 26525-5003
Phone
(304) 379-7600
Fax
(833) 448-0362
NPI assigned
Sep 19, 2012
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 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 52464 WV
Family Nurse Practitioner 363LF0000X APRN52464 WV Primary

Addresses

Primary practice location

198 Morgantown St Ste 2
Bruceton Mills, WV 26525-5003

Mailing address

198 Morgantown St Ste 2
Bruceton Mills, WV 26525-5003
Phone (304) 379-7600

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
I20130427000099 WV Practitioner - Nurse Practitioner 4587800180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

198 Morgantown St
Suite 2
Bruceton Mills, WV 26525-5003
Phone (304) 379-7600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
52464WVMDFamily Nurse Practitioner
APRN52464WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Maryland Health Care Corporation CurrentSince Aug 15, 2023 Accepting new patients
Western Maryland Health Care Corporation CurrentSince Aug 15, 2023 Accepting new patients
Western Maryland Health Care Corporation Past Accepting new patients
Western Maryland Health Care Corporation Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

198 Morgantown St
Ste 2
Bruceton Mls, WV 26525
Phone (304) 379-7600

Interoperability endpoints

  • Direct secure messaging: alysia.funk.1@28818.direct.athenahealth.com

Organizations & group practices 6

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 5

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": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1861742629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 MORGANTOWN ST STE 2",
            "city": "BRUCETON MILLS",
            "state": "WV",
            "postal_code": "265255003",
            "telephone_number": "304-379-7600",
            "fax_number": "334-488-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 MORGANTOWN ST STE 2",
            "city": "BRUCETON MILLS",
            "state": "WV",
            "postal_code": "265255003",
            "telephone_number": "304-379-7600",
            "fax_number": "833-448-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "ALYSIA",
        "middle_name": "RENEE",
        "name_prefix": "Miss",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "52464",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN52464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bruceton Mills, WV

Sources for this page

Verify at the official NPI Registry.