James Pack
Individual provider Active NPI Community Health Worker · Daniels, WV
NPI 1023601036 · NPPES record last updated Feb 19, 2021
Key facts
- NPI
- 1023601036
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 109 Kayo LN
Daniels, WV 25832-9320 - Phone
- (304) 253-2801
- NPI assigned
- Feb 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
109 Kayo LN
Daniels, WV 25832-9320
Mailing address
PO Box 798
Daniels, WV 25832-0798
Other providers in Daniels, WV
- Dana Melroy
- Sandra Morgan
- Lily Payton Myles
- Amanda Leigh Neal
- Kera Nunn
- Angela Marie Pendleton
- Performance Physical Therapy and Rehabilitation
- Suzette Peterson
- Prompt Care Plus, MC
- Raleigh Center Opco, LLC
All providers in Daniels, WV · Community Health Worker in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.