Individual provider Active NPI

Jacqueline Richmond

  • Personal Care Attendant
  • Beckley, WV
National Provider Identifier
1104574912
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
150 Autumn LN Apt 2H
Beckley, WV 25801-2948
Phone
(304) 719-5520
NPI assigned
Mar 11, 2022
Last updated
Mar 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X NU Primary

Addresses

Primary practice location

150 Autumn LN Apt 2H
Beckley, WV 25801-2948

Mailing address

150 Autumn LN Apt 2H
Beckley, WV 25801-2948
Phone (304) 719-5520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1104574912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 AUTUMN LN APT 2H",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012948",
            "telephone_number": "304-719-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 AUTUMN LN APT 2H",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012948",
            "telephone_number": "304-719-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHMOND",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 11, 2022; 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.