NPIMap

Organization Active NPI

Jeannie Healthcare Incorporation

  • Exclusive Provider Organization
  • Charleston, WV
National Provider Identifier
1063731107
Registry record updated May 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
99FMG Issued in WV
Legal business name
JEANNIE HEALTHCARE INCORPORATION
Practice address
1406 Madison St
Charleston, WV 25312-2417
Phone
(304) 345-2014
NPI assigned
May 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2010

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

Authorized official

Name
Jeannie Laticia StewartNPI 1194045435
Title
Ceo/President
Phone
(304) 345-2014

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 99FMG WV Primary

Addresses

Primary practice location

1406 Madison St
Charleston, WV 25312-2417

Mailing address

1406 Madison St
196 Wertz Ave.
Charleston, WV 25312-2417
Phone (304) 345-2014

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275004800000",
    "number": "1063731107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 MADISON ST",
            "address_2": "196 WERTZ AVE.",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253122417",
            "telephone_number": "304-345-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 MADISON ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253122417",
            "telephone_number": "304-345-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANNIE HEALTHCARE INCORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-28",
        "last_updated": "2010-05-28",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_middle_name": "LATICIA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "304-345-2014"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "WV",
            "license": "99FMG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; 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.