NPIMap

Individual provider Active NPI

Shana F Wandling, RN, FNP-BC

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1861793358
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
58591 Issued in WV
Practice address
6135 Sissonville Dr
Charleston, WV 25312-9444
Phone
(304) 984-1576
Fax
(304) 984-1565
NPI assigned
Nov 15, 2010
Last updated
May 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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 58591 WV Primary

Addresses

Primary practice location

6135 Sissonville Dr
Charleston, WV 25312-9444

Mailing address

107 Koontz Ave
Clendenin, WV 25045-9578
Phone (304) 548-7272

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
I20110331000199 WV Practitioner - Nurse Practitioner 0840473641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cabin Creek Health Center IncGroup PAC ID 2466431101, 41 clinicians

Practice addresses (Care Compare)

107 Koontz Ave
Suite 200
Clendenin, WV 25045-9581
Phone (304) 548-7272

6135 Sissonville Dr
Charleston, WV 25312-9444
Phone (304) 984-1576

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cabin Creek Health Center, Inc. CurrentSince Jun 24, 2015 Accepting new patients
Cabin Creek Health Center, Inc. Current Accepting new patients
Cabin Creek Health Center Inc CurrentSince Jun 24, 2015 Accepting new patients
Clendenin Health Center Pharmacy at Riverview Past Accepting new patients
Patel Inc. Past Accepting new patients

Locations

1 Warrior Way
Ste 103
Belle, WV 25015
Phone (304) 949-3591

4602 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 205-7535

6135 Sissonville Dr
Charleston, WV 25312
Phone (304) 984-1576

107 Koontz Ave
Ste 200
Clendenin, WV 25045
Phone (304) 548-7272

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7267/brand/1/csg/1/fhir/r4
  • Direct secure messaging: shana.wandling.1@7267.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 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": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1861793358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 KOONTZ AVE",
            "city": "CLENDENIN",
            "state": "WV",
            "postal_code": "250459578",
            "telephone_number": "304-548-7272",
            "fax_number": "304-548-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 SISSONVILLE DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253129444",
            "telephone_number": "304-984-1576",
            "fax_number": "304-984-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDLING",
        "first_name": "SHANA",
        "middle_name": "F",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "58591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.