NPIMap

Organization Active NPI

Monarch Wound Care LLC

  • Physical Therapist
  • Morgantown, WV
National Provider Identifier
1124806831
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MONARCH WOUND CARE LLC
Practice address
200 Fort Pierpont Dr Ste 105
Morgantown, WV 26508-1327
Phone
(304) 241-7667
Fax
(304) 241-7568
NPI assigned
Sep 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Authorized official

Name
Jacqueline J Gay, DPT, CWSNPI 1912546789
Title
Owner, Provider
Phone
(304) 241-7667

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
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

200 Fort Pierpont Dr Ste 105
Morgantown, WV 26508-1327

Mailing address

200 Fort Pierpont Dr Ste 105
Morgantown, WV 26508-1327
Phone (304) 241-7667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231016002103 WV Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9436504180 Receives reassigned benefits from 4 practitioners
Practice locations: Morgantown, WV
O20250306000192 WV DME Supplier - Independently-Practicing Physical Therapist 9436504180 Practice locations: Morgantown, WV

National Provider Directory

National Provider Directory

Locations

200 Fort Pierpont Dr
Ste 105
Morgantown, WV 26508
Phone (304) 241-7667

Practitioners & affiliated clinicians

Practitioners 6

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": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1124806831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FORT PIERPONT DR STE 105",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081327",
            "telephone_number": "304-241-7667",
            "fax_number": "304-241-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FORT PIERPONT DR STE 105",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081327",
            "telephone_number": "304-241-7667",
            "fax_number": "304-241-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONARCH WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER, PROVIDER",
        "authorized_official_telephone_number": "304-241-7667",
        "authorized_official_credential": "DPT, CWS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.