NPIMap

Organization Active NPI

Mountain Empire Older Citizens, Inc

Doing business as Mountain Empire PACE

  • PACE Provider Organization
  • Big Stone Gap, VA
National Provider Identifier
1184807661
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
MOUNTAIN EMPIRE OLDER CITIZENS, INC
Doing business as
Mountain Empire PACE
Practice address
1501 3Rd Ave E
Big Stone Gap, VA 24219-3115
Phone
(276) 523-4202
Fax
(276) 523-4208
NPI assigned
Dec 7, 2007
Last updated
Jun 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Authorized official

Name
Mr. Michael K Wampler
Title
Executive Director
Phone
(276) 523-4202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

1501 3Rd Ave E
Big Stone Gap, VA 24219-3115

Mailing address

PO Box 888
1-A Industrial Park Road
Big Stone Gap, VA 24219-0888
Phone (276) 523-4202

Other names 1

  • Mountain Empire PACE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mountain Empire Older Citizens Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1184807661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888",
            "address_2": "1-A INDUSTRIAL PARK ROAD",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242190888",
            "telephone_number": "276-523-4202",
            "fax_number": "276-523-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 3RD AVE E",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193115",
            "telephone_number": "276-523-4202",
            "fax_number": "276-523-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN EMPIRE OLDER CITIZENS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "WAMPLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "276-523-4202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Empire PACE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain Empire PACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Big Stone Gap, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.