NPIMap

Organization Active NPI

Wetzel County Coa

  • In Home Supportive Care Agency
  • New Martinsville, WV
National Provider Identifier
1053455113
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
10363962 Issued in WV
Legal business name
WETZEL COUNTY COA
Practice address
145 Paducah Dr
New Martinsville, WV 26155-2709
Phone
(304) 455-3044
Fax
(304) 455-0280
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Authorized official

Name
Cynthia Hall Culley, REGISTER NURSE
Title
Register Nurse
Phone
(304) 455-3220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 10363962 WV Primary

Addresses

Primary practice location

145 Paducah Dr
New Martinsville, WV 26155-2709

Mailing address

145 Paducah Dr
New Martinsville, WV 26155-2709
Phone (304) 455-3044

Other identifiers 3

IdentifierTypeStateIssuer
0030804001MedicaidWV
0030804002MedicaidWV
0030804000MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Wetzel County Coa3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1053455113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 PADUCAH DR",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261552709",
            "telephone_number": "304-455-3044",
            "fax_number": "304-455-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PADUCAH DR",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261552709",
            "telephone_number": "304-455-3044",
            "fax_number": "304-455-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WETZEL COUNTY COA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "CULLEY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "HALL",
        "authorized_official_title_or_position": "REGISTER NURSE",
        "authorized_official_telephone_number": "304-455-3220",
        "authorized_official_credential": "REGISTER NURSE"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WV",
            "license": "10363962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030804001",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030804002",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030804000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Martinsville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.