Junction Center for Independent Living, Inc.

Primary specialty

ContractorTaxonomy code 171W00000X

License

008744041 Issued in VA

Legal business name

JUNCTION CENTER FOR INDEPENDENT LIVING, INC.

Practice address

1520 3Rd Ave E
Big Stone Gap, VA 24219-3114

Phone

(276) 524-4081

Fax

(276) 524-1510

NPI assigned

Apr 23, 2007

Last updated

Jan 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sharon Stacey

Title

Program Director

Phone

(276) 524-4081

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1376761304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 3RD AVE E",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193114",
            "telephone_number": "276-524-4081",
            "fax_number": "276-524-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 3RD AVE E",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193114",
            "telephone_number": "276-524-4081",
            "fax_number": "276-524-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNCTION CENTER FOR INDEPENDENT LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "STACEY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "276-524-4081"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "VA",
            "license": "008744041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008743908",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376761304",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008744041",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Intrepid of the Rolling Hills, Inc. (Intrepid USA Healthcare Services)
• Adrienne Ann Johnson, BS
• Jerelene Elizabeth Johnson
• Rebecca Ely Johnson, RN
• Shandolyn Gail Johnson, BS
• K-VA-T Food Stores Inc (Food City Pharmacy)
• James Dale Kegley, MS
• Gerald Bryan Kelley, D.D.S.
• Tanner Brent Kennedy, PT, DPT
• Kevin M Allred DDS PC (Powell Valley Dental)

• Contractor in Big Stone Gap, VA
• Providers in Big Stone Gap, VA by specialty
• Contractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.