Organization Active NPI

Jan-Care Ambulance of Nicholas Co, Inc

  • Land Ambulance
  • Beckley, WV
National Provider Identifier
1487635116
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 NICHOLAS CO, INC
Practice address
117 South Fayette Street
Beckley, WV 25801-9056
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 South Fayette Street
Beckley, WV 25801-9056

Mailing address

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

Other practice location 1

1112 Broad St
Summersville, WV 26651-1804
Phone (304) 255-2931

Other identifiers 4

IdentifierTypeStateIssuer
1032236200001MedicaidPA
001705328OtherWVBCBS OF WV
0328916MedicaidOH
0145332000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061218000087 WV Part B Supplier - Ambulance Service Supplier 3678572864 Practice locations: Beckley, WV; Summersville, WV

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D1001921Jan Care Ambulance of Nicholas Co Inc1112 Broad Street, Summersville, WV 26651Certificate of waiverJul 23, 2028

National Provider Directory

National Provider Directory

Locations

1112 Broad St
Summersville, WV 26651
Phone (304) 872-4202

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": "1487635116",
    "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 SOUTH FAYETTE STREET",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258019056",
            "telephone_number": "304-255-2931",
            "fax_number": "304-255-0222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1112 Broad St",
            "address_purpose": "LOCATION",
            "city": "Summersville",
            "state": "WV",
            "postal_code": "266511804",
            "country_code": "US",
            "telephone_number": "304-255-2931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAN-CARE AMBULANCE OF NICHOLAS CO, 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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032236200001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WV",
            "identifier": "001705328",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0328916",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145332000",
            "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.
  • 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.