NPIMap

Organization Active NPI

Home Base Inc Mdgrp

  • Community/Behavioral Health Agency
  • Buckhannon, WV
National Provider Identifier
1154596757
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
135 Issued in WV
Legal business name
HOME BASE INC MDGRP
Practice address
5 1/2 W Main St
Buckhannon, WV 26201-2235
Phone
(304) 472-8707
Fax
(304) 472-8978
NPI assigned
Apr 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Mr. Damon C. Cater
Title
Ceo
Phone
(304) 472-8707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 135 WV Primary

Addresses

Primary practice location

5 1/2 W Main St
Buckhannon, WV 26201-2235

Mailing address

PO Box 2024
Buckhannon, WV 26201-7024
Phone (304) 472-8707

Other identifiers 1

IdentifierTypeStateIssuer
3810007185MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Home Base Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

5 W Main St
Buckhannon, WV 26201
Phone (304) 472-8707

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1154596757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2024",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262017024",
            "telephone_number": "304-472-8707",
            "fax_number": "304-472-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 1/2 W MAIN ST",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012235",
            "telephone_number": "304-472-8707",
            "fax_number": "304-472-8978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME BASE INC MDGRP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "CATER",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-472-8707",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WV",
            "license": "135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810007185",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckhannon, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.