NPIMap

Organization Active NPI

St. Joseph Recovery Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Parkersburg, WV
National Provider Identifier
1174021406
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ST. JOSEPH RECOVERY CENTER, LLC
Practice address
1824 Murdoch Ave BLDG C
Parkersburg, WV 26101-3230
Phone
(304) 916-1881
NPI assigned
Feb 1, 2018
Last updated
Feb 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Authorized official

Name
Donna J MeadowsNPI 1598827057
Title
Ceo
Phone
(304) 916-1881

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X

Addresses

Primary practice location

1824 Murdoch Ave BLDG C
Parkersburg, WV 26101-3230

Mailing address

1824 Murdoch Ave BLDG C
Parkersburg, WV 26101-3230
Phone (304) 916-1881

Other identifiers 1

IdentifierTypeStateIssuer
1174021406MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190829000101 WV Part B Supplier - Clinic/Group Practice 0042548000 Receives reassigned benefits from 16 practitioners
Practice locations: Parkersburg, WV; Summersville, WV
O20250520000323 OH Part B Supplier - Clinic/Group Practice 0042548000 Receives reassigned benefits from 5 practitioners
Practice locations: Cambridge, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2160759St Joseph Recovery Center1824 Murdoch Ave, Building C, Parkersburg, WV 26101Certificate of waiverJan 16, 2027

National Provider Directory

National Provider Directory

Locations

2146 Southgate Pkwy
Ste 5
Cambridge, OH 43725
Phone (740) 370-6404

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1174021406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 MURDOCH AVE BLDG C",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261013230",
            "telephone_number": "304-916-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MURDOCH AVE BLDG C",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261013230",
            "telephone_number": "304-916-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "MEADOWS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-916-1881"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174021406",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.