Mountaineer Home Medical, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

MOUNTAINEER HOME MEDICAL, LLC

Practice address

220 N Kanawha St Ste 3
Beckley, WV 25801-4745

Phone

(304) 225-6290

NPI assigned

Jun 7, 2024

Organization subpart

No

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

Authorized official

Name

Michelle Jackson

Title

Collections Manager

Phone

(304) 225-6290

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Mountaineer Home Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Morgantown, WV
  • NPI 1760474852

  0840400263

  Same PAC ID
• Mountaineer Home Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Cumberland, MD
  • NPI 1356007785

  0840400263

  Same PAC ID
• Mountaineer Home Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Barco, NC
  • NPI 1518720754

  0840400263

  Same PAC ID

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

Medicare medical equipment & supply locations

Tax ID family

Mountaineer Home Medical LLC5 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.

• Mountaineer Home Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Morgantown, WV
  • NPI 1760474852
  NPD tax ID
• Mountaineer Home Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Princeton, WV
  • NPI 1912862590
  NPD tax ID
• Mountaineer Home Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Cumberland, MD
  • NPI 1356007785
  NPD tax ID
• Mountaineer Home Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Barco, NC
  • NPI 1518720754
  NPD tax ID

Locations

Practitioners 1

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

• Richard William Brant, M.D.

  • Pediatrics Physician
  • Morgantown, WV
  • NPI 1760775266
  NPD (past)

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777593600000",
    "number": "1225870629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 GREENBAG RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265017163",
            "telephone_number": "304-225-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N KANAWHA ST STE 3",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014745",
            "telephone_number": "304-225-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER HOME MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-07",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "COLLECTIONS MANAGER",
        "authorized_official_telephone_number": "304-225-6290"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountain State Home Health Care Inc
• Mountain State Home Health Care, Inc.
• Mountain State Vascular, Inc.
• Mountaineer Cardiovascular Care Inc
• Mountaineer Family Medicine Inc
• Mountaineer Wellness and Recovery Centers LLC
• Daniel Moye II
• Brittany Mullens
• Adrienne Mullins
• James Russell Mullins

• Oxygen Equipment & Supplies (DME) in Beckley, WV
• Providers in Beckley, WV by specialty
• Oxygen Equipment & Supplies (DME) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.