NPIMap

Organization Active NPI

MSRC, LLC

  • Community/Behavioral Health Agency
  • Charleston, WV
National Provider Identifier
1194294587
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MSRC, LLC
Practice address
102 Patrick Street PLZ
Charleston, WV 25387-2444
Phone
(304) 941-9779
NPI assigned
Nov 15, 2018
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Joseph Shaffer
Title
Coo
Phone
(859) 489-2705

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 37

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251103002648 WV Part B Supplier - Clinic/Group Practice 6800122896 Receives reassigned benefits from 8 practitioners
Practice locations: Huntington, WV; Charleston, WV

National Provider Directory

National Provider Directory
Tax ID family
Mountain State Recovery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Clinical Medical Laboratory 291U00000X

Addresses

NPPES NPI Registry

Primary practice location

102 Patrick Street PLZ
Charleston, WV 25387-2444

Mailing address

8 River Walk Mall
South Charleston, WV 25303-1026

Other practice location 1

650 Washington Ave
Huntington, WV 25701-1042
Phone (304) 233-3200

Other names 1

NPPES NPI Registry
  • Mountain State Recovery Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 15, 2024.

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1194294587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 RIVER WALK MALL",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PATRICK STREET PLZ",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253872444",
            "telephone_number": "304-941-9779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257011042",
            "country_code": "US",
            "telephone_number": "304-233-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MSRC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "859-489-2705"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain State Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.