NPIMap

Individual provider Active NPI

Mariah Nicole Boggess, APRN-CNP

  • Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1942024682
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
121170 Issued in WV
Practice address
3415 Maccorkle Ave SE
Charleston, WV 25304-1334
Phone
(304) 388-8380
NPI assigned
Nov 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 121170 WV Primary

Addresses

Primary practice location

3415 Maccorkle Ave SE
Charleston, WV 25304-1334

Mailing address

3415 Maccorkle Ave SE
Charleston, WV 25304-1334
Phone (304) 388-8380

Other identifiers 1

IdentifierTypeStateIssuer
1942024682MedicaidWV

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
I20260225000892 WV Practitioner - Nurse Practitioner 1951882232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3415 Maccorkle Ave SE
Charleston, WV 25304-1334
Phone (304) 388-8380

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
121170WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Jan 10, 2026 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Jan 10, 2026 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

3415 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-1790

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700

1401 Hospital Dr
Ste 201
Hurricane, WV 25526
Phone (304) 388-4949

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": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1942024682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041334",
            "telephone_number": "304-388-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041334",
            "telephone_number": "304-388-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGESS",
        "first_name": "MARIAH",
        "middle_name": "NICOLE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "121170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942024682",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.