Individual provider Active NPI

Carol McLennan, FNP-C

  • Nurse Practitioner
  • Bridgeport, WV
National Provider Identifier
1871969717
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
92122 Issued in WV
Practice address
710 Genesis Blvd
Bridgeport, WV 26330-9668
Phone
(681) 342-3490
Fax
(681) 342-3491
NPI assigned
Aug 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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 92122 WV
Nurse Practitioner 363L00000X 92122 WV Primary

Addresses

Primary practice location

710 Genesis Blvd
Bridgeport, WV 26330-9668

Mailing address

527 Medical Park Dr Ste 400
Bridgeport, WV 26330-9010
Phone (681) 342-3490

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
I20180521000918 WV Practitioner - Nurse Practitioner 4284999319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Hospital Center IncGroup PAC ID 8123936010, 290 clinicians

Practice addresses (Care Compare)

120 Medical Park Dr
Suite 100
Bridgeport, WV 26330-9013
Phone (681) 342-3490

327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1842

527 Medical Park Dr
Bridgeport, WV 26330-9010

916 W Main St
Bridgeport, WV 26330-1651
Phone (304) 842-1034

PO Box
Suite 775
Morgantown, WV 26507-0775

Hospital & facility affiliations

  • United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006
  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001
  • St Joseph'S Hospital of Buckhannon, Inc Hospital, Buckhannon, WV, CCN 511321
  • Braxton County Memorial Hospital, Inc Hospital, Gassaway, WV, CCN 511308

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
92122WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Hospital Center, Inc. CurrentSince May 7, 2018 Accepting new patients
United Hospital Center, Inc. CurrentSince May 7, 2018 Accepting new patients
United Hospital Center Past Accepting new patients

Locations

527 Medical Park Dr
Ste 400
Bridgeport, WV 26330
Phone (681) 342-1610

710 Genesis Blvd
Bridgeport, WV 26330
Phone (681) 342-3070

120 Medical Park Dr
Ste 100
Bridgeport, WV 26330
Phone (304) 842-3278

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

916 W Main St
Bridgeport, WV 26330
Phone (304) 842-1034

2673 Davisson Run Rd
Ste 303
Clarksburg, WV 26301

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1871969717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 400",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "681-342-3490",
            "fax_number": "681-342-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 GENESIS BLVD",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309668",
            "telephone_number": "681-342-3490",
            "fax_number": "681-342-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLENNAN",
        "first_name": "CAROL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-14",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "92122",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "92122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.