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PHOENIX RISING HEALTHCARE
NPI 1093284937
Nurse Practitioner - Primary Care in Fairmont, WV

Active since November 21, 2018
5 ERWIN LN STE A, FAIRMONT, WV 26554(304) 366-0111(304) 366-2099 Get Directions Write a Review

NPPES record last updated: October 15, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 15, 2020, Nov 21, 2018 (2 updates tracked since 2018).

About Phoenix Rising Healthcare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHOENIX RISING HEALTHCARE (NPI 1093284937) is a healthcare organization registered as a primary care in Fairmont, West Virginia and active in the NPI registry since November 2018. The organization lists Traci Tannehill, Managing Member Of Llc, as its authorized official.

NPPES Registry Identity

NPI1093284937
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NamePHOENIX RISING HEALTHCARE
Location Address5 ERWIN LN STE AFairmont, WV 26554-1376
Mailing AddressPo Box 1286Fairmont, WV 26555-1286 · (304) 366-0111 · Fax (304) 366-2099
Phone(304) 366-0111
Fax(304) 366-2099
Organization SubpartNo
Authorized OfficialTraci TannehillManaging Member Of Llc · (304) 366-0111
Enumeration DateNovember 21, 2018
Last NPPES UpdateOctober 15, 20202 updates tracked since enumeration
NPPES CertifiedOctober 15, 2020
✔ NPI 1093284937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
5 ERWIN LN STE A, Fairmont, WV 26554
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRACI LAYNE TANNEHILL FNP-BC
Nurse Practitioner (Family)
5 ERWIN LN STE A
FAIRMONT, WV 26554
Marion County (304) 366-0111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phoenix Rising Healthcare's NPI number?

The NPI number for Phoenix Rising Healthcare is 1093284937. It was assigned to this organization in the NPPES registry on November 21, 2018.

Where is Phoenix Rising Healthcare located?

Phoenix Rising Healthcare is located at 5 Erwin Ln Ste A, Fairmont, WV 26554. The listed phone number is (304) 366-0111.

What is Phoenix Rising Healthcare's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

What insurance does Phoenix Rising Healthcare accept?

Health plans from CareSource list Phoenix Rising Healthcare as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Phoenix Rising Healthcare was last updated on October 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.