NPIMap

Organization Active NPI

Doddridge Co Senior Citizen

  • Home Health Agency
  • West Union, WV
National Provider Identifier
1417124223
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DODDRIDGE CO SENIOR CITIZEN
Practice address
403 W Main St
P.O. 432
West Union, WV 26456-1127
Phone
(304) 873-2061
Fax
(304) 873-1769
NPI assigned
May 12, 2008
Last updated
Nov 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Authorized official

Name
Marvin E Travis
Title
Director
Phone
(304) 873-2061

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary
Homemaker 376J00000X NU

Addresses

Primary practice location

403 W Main St
P.O. 432
West Union, WV 26456-1127

Mailing address

403 W Main St
P.O. 432
West Union, WV 26456-1127
Phone (304) 873-2061

Other identifiers 1

IdentifierTypeStateIssuer
0030953001MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Doddridge Co Senior Citizen4 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.

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1417124223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W MAIN ST",
            "address_2": "P.O. 432",
            "city": "WEST UNION",
            "state": "WV",
            "postal_code": "264561127",
            "telephone_number": "304-873-2061",
            "fax_number": "304-873-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W MAIN ST",
            "address_2": "P.O. 432",
            "city": "WEST UNION",
            "state": "WV",
            "postal_code": "264561127",
            "telephone_number": "304-873-2061",
            "fax_number": "304-873-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODDRIDGE CO SENIOR CITIZEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "TRAVIS",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "304-873-2061"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030953001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Union, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.