NPIMap

Organization Active NPI

Professional Care Case Management, LLC

  • Case Management Agency
  • Elkins, WV
National Provider Identifier
1598338659
Registry record updated Jul 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
PROFESSIONAL CARE CASE MANAGEMENT, LLC
Practice address
19 Main St
Elkins, WV 26241-3125
Phone
(304) 635-7740
Fax
(304) 635-7742
NPI assigned
Jul 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2021

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

Authorized official

Name
Wendy Michelle Collins, RNNPI 1154709095
Title
Director
Phone
(304) 635-7740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

19 Main St
Elkins, WV 26241-3125

Mailing address

19 Main St
Elkins, WV 26241-3125
Phone (304) 635-7740

Other identifiers 3

IdentifierTypeStateIssuer
1154709095MedicaidWV
15787179149MedicaidWV
1700409067MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Professional Care Case Management LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1626480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626480000000",
    "number": "1598338659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MAIN ST",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262413125",
            "telephone_number": "304-635-7740",
            "fax_number": "304-635-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MAIN ST",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262413125",
            "telephone_number": "304-635-7740",
            "fax_number": "304-635-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CARE CASE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-17",
        "last_updated": "2021-07-17",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "304-635-7740",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154709095",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15787179149",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700409067",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2021; 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.