Organization Active NPI

Jan-Care Ambulance of the Kanawha & Mid-Ohio Valleys Inc

  • Land Ambulance
  • Beckley, WV
National Provider Identifier
1104247113
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
JAN-CARE AMBULANCE OF THE KANAWHA & MID-OHIO VALLEYS INC
Practice address
117 S Fayette St
Beckley, WV 25801-4606
Phone
(304) 255-2931
Fax
(304) 255-0222
NPI assigned
Dec 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
Mr. Joseph T Cornett
Title
Vice President
Phone
(304) 255-2931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X WV Primary

Addresses

Primary practice location

117 S Fayette St
Beckley, WV 25801-4606

Mailing address

PO Box 2414
Beckley, WV 25802-2414
Phone (304) 255-2931

Other practice location 1

4821 McClung St # A
South Charleston, WV 25309-2011
Phone (304) 255-2931

Other practice location 2

1515 Camden Ave
Parkersburg, WV 26101-5540
Phone (304) 255-2931

Other practice location 3

231 Straight St
Ripley, WV 25271-1116
Phone (330) 425-5293

Other identifiers 4

IdentifierTypeStateIssuer
0193905MedicaidOH
3041056OtherWVBCBS WV
3910000667MedicaidWV
1032235950001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140215000206 WV Part B Supplier - Ambulance Service Supplier 7315176385 Practice locations: Parkersburg, WV; Beckley, WV; South Charleston, WV; Ripley, WV

National Provider Directory

National Provider Directory

Locations

1515 Camden Ave
Parkersburg, WV 26101

231 Straight St
Ripley, WV 25271
Phone (330) 425-5293

4821 McClung St
#A
South Charleston, WV 25309

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1104247113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2414",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258022414",
            "telephone_number": "304-255-2931",
            "fax_number": "304-255-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S FAYETTE ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014606",
            "telephone_number": "304-255-2931",
            "fax_number": "304-255-0222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4821 McClung St # A",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253092011",
            "country_code": "US",
            "telephone_number": "304-255-2931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 Camden Ave",
            "address_purpose": "LOCATION",
            "city": "Parkersburg",
            "state": "WV",
            "postal_code": "261015540",
            "country_code": "US",
            "telephone_number": "304-255-2931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "231 Straight St",
            "address_purpose": "LOCATION",
            "city": "Ripley",
            "state": "WV",
            "postal_code": "252711116",
            "country_code": "US",
            "telephone_number": "330-425-5293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAN-CARE AMBULANCE OF THE KANAWHA & MID-OHIO VALLEYS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "CORNETT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "304-255-2931",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0193905",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS WV",
            "identifier": "3041056",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3910000667",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032235950001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.