Individual provider Active NPI

Mindy L Bostic, PNP

  • Pediatric Nurse Practitioner
  • Camden on Gauley, WV
National Provider Identifier
1871880856
Registry record updated Mar 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
57113 Issued in WV
Practice address
10003 Webster Rd
Camden on Gauley, WV 26208-7713
Phone
(304) 226-5725
NPI assigned
Jun 29, 2011
Last updated
Mar 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 57113 WV Primary

Addresses

Primary practice location

10003 Webster Rd
Camden on Gauley, WV 26208-7713

Mailing address

415 Main St
Summersville, WV 26651-1343
Phone (304) 872-1663

Other practice location 1

415 Main St
Summersville, WV 26651-1343
Phone (304) 872-1663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111013000594 WV Practitioner - Nurse Practitioner 3577735638 Reassigns benefits to 13 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57113WVMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Camden on Gauley Medical Center Inc CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Mar 14, 2024 Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center, Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center, Inc CurrentSince Mar 23, 2024 Accepting new patients
Camden on Gauley Medical Center, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center Inc. CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Apr 1, 2024 Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Feb 1, 2025 Accepting new patients

Locations

101 Florence St
Ansted, WV 25812
Phone (304) 658-5100

10003 Webster Rd
Camden on Gly, WV 26208
Phone (304) 266-5725

56 Park St
Cowen, WV 26206
Phone (304) 226-5275

100 School St
Craigsville, WV 26205
Phone (304) 742-1061

16414 Webster Rd
Craigsville, WV 26205
Phone (304) 742-3004

46 Red Oak Dr
Craigsville, WV 26205
Phone (304) 742-5737

1945 E Mount Lookout Rd
Mount Lookout, WV 26678

110 Panther Creek Elementary Rd
Nettie, WV 26681
Phone (304) 742-1061

16 W Main St
Richwood, WV 26261
Phone (304) 846-0207

190 Riverside Dr
Richwood, WV 26261
Phone (304) 846-2588

190 Riverside Dr
Rm 2109
Richwood, WV 26261
Phone (304) 846-2588

71 Avenue A
Richwood, WV 26261
Phone (304) 846-2608

415 Main St
Summersville, WV 26651
Phone (304) 872-1663

70 Grade School Ln
Summersville, WV 26651
Phone 3042265725118

1 Highlander Dr
Upperglade, WV 26266
Phone (304) 226-3993

300 Minuteman Dr
Weston, WV 26452
Phone (304) 997-8701

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710547200000",
    "number": "1871880856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511343",
            "telephone_number": "304-872-1663",
            "fax_number": "304-226-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10003 WEBSTER RD",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262087713",
            "telephone_number": "304-226-5725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Main St",
            "address_purpose": "LOCATION",
            "city": "Summersville",
            "state": "WV",
            "postal_code": "266511343",
            "country_code": "US",
            "telephone_number": "304-872-1663",
            "fax_number": "304-226-3274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSTIC",
        "first_name": "MINDY",
        "middle_name": "L",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2024-03-16",
        "certification_date": "2024-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WV",
            "license": "57113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden on Gauley, WV

Sources for this page

Verify at the official NPI Registry.