NPIMap

Organization Active NPI

Change Inc Family Medical Care

  • Developmentally Disabled Services Day Training Agency
  • Weirton, WV
National Provider Identifier
1154579936
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
CHANGE INC FAMILY MEDICAL CARE
Practice address
3136 West St
Weirton, WV 26062-4637
Phone
(304) 748-2828
NPI assigned
Sep 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Authorized official

Name
Amanda Grace Raveaux
Title
Billing Manager
Phone
(304) 748-2828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

3136 West St
Weirton, WV 26062-4637

Mailing address

3136 West St
Weirton, WV 26062-4637
Phone (304) 748-2828

Other identifiers 1

IdentifierTypeStateIssuer
3810012462MedicaidWV

Other names 1

  • CHANGE INC Other name

National Provider Directory

National Provider Directory
Tax ID family
Change Incorporated8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3136 West St
Weirton, WV 26062
Phone (304) 748-2828

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1154579936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 WEST ST",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260624637",
            "telephone_number": "304-748-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 WEST ST",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260624637",
            "telephone_number": "304-748-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE INC FAMILY MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "RAVEAUX",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "304-748-2828"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012462",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHANGE INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.