Organization Active NPI

Jan-Care Ambulance of Tri State Division Inc

  • Land Ambulance
  • Beckley, WV
National Provider Identifier
1366423014
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
JAN-CARE AMBULANCE OF TRI STATE DIVISION INC
Practice address
117 S Fayette St
Beckley, WV 25801-4606
Phone
(304) 255-2931
Fax
(304) 255-0222
NPI assigned
Nov 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
Mr. Joseph T Cornett
Title
Vice President
Phone
(304) 255-2931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X WV Primary

Addresses

Primary practice location

117 S Fayette St
Beckley, WV 25801-4606

Mailing address

PO Box 2414
Beckley, WV 25802-2414
Phone (304) 255-2931

Other practice location 1

1301 7th Ave
Huntington, WV 25701-2965
Phone (304) 255-2931

Other practice location 2

6702 Old NW Railroad Rd
Genoa, WV 25517-8077
Phone (304) 255-2931

Other identifiers 4

IdentifierTypeStateIssuer
001705599OtherWVBCBS OF WV
1032235860001MedicaidPA
0193886MedicaidOH
3810008674MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061221000201 WV Part B Supplier - Ambulance Service Supplier 6800894627 Practice locations: Huntington, WV; Beckley, WV

National Provider Directory

National Provider Directory

Locations

2915 S 4th St
Ironton, OH 45638

1301 7th Ave
Huntington, WV 25701

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1366423014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2414",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258022414",
            "telephone_number": "304-255-2931",
            "fax_number": "304-255-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S FAYETTE ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014606",
            "telephone_number": "304-255-2931",
            "fax_number": "304-255-0222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257012965",
            "country_code": "US",
            "telephone_number": "304-255-2931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6702 Old NW Railroad Rd",
            "address_purpose": "LOCATION",
            "city": "Genoa",
            "state": "WV",
            "postal_code": "255178077",
            "country_code": "US",
            "telephone_number": "304-255-2931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAN-CARE AMBULANCE OF TRI STATE DIVISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "CORNETT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "304-255-2931",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WV",
            "identifier": "001705599",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032235860001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0193886",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810008674",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.