Cathy Pollis

Individual provider Active NPI Licensed Practical Nurse · Charleston, WV

NPI 1124742275 · NPPES record last updated Oct 3, 2022

Key facts

NPI
1124742275
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
27674 (WV)
Practice address
400 Tracy Way Ste 100
Charleston, WV 25311-1280
Phone
(304) 720-0205
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
27674WVMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care at Home of West Virginia, LLC Past
since Oct 9, 2022
Accepting new patients
Mountaineer Homecare, LLC Past
since Oct 9, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 27674 WV Yes

Addresses

Primary practice location

400 Tracy Way Ste 100
Charleston, WV 25311-1280

Mailing address

400 Tracy Way Ste 100
Charleston, WV 25311-1280
Phone (304) 720-0205

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Desktop/Tablet
CONNECT URL desktop/tablet

Other providers in Charleston, WV

All providers in Charleston, WV · Licensed Practical Nurse in West Virginia

Sources for this page

Verify at the official NPI Registry.