NPIMap

Organization Active NPI

Change Incorporated

Doing business as Family Medical Care

  • Federally Qualified Health Center (FQHC)
  • Newell, WV
National Provider Identifier
1174074686
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHANGE INCORPORATED
Doing business as
Family Medical Care
Practice address
1151 Washington St
Newell, WV 26050
Phone
(304) 459-4010
Fax
(304) 797-7740
NPI assigned
Oct 19, 2016
Last updated
Oct 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Authorized official

Name
Judy Raveaux
Title
Ceo
Phone
(304) 797-7733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1151 Washington St
Newell, WV 26050

Mailing address

3158 West Street
Weirton, WV 26062
Phone (304) 459-4010

Other names 1

  • Family Medical Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Change Inc8 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

1151 Washington St
Newell, WV 26050
Phone (304) 459-4010

3158 West St
Weirton, WV 26062
Phone (304) 797-7733

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1174074686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 WEST STREET",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "26062",
            "telephone_number": "304-459-4010",
            "fax_number": "304-723-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 WASHINGTON ST",
            "city": "NEWELL",
            "state": "WV",
            "postal_code": "26050",
            "telephone_number": "304-459-4010",
            "fax_number": "304-797-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "RAVEAUX",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-797-7733"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newell, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.