NPIMap

Organization Active NPI

Nicholas Community Action Partnership, Inc.

  • Point of Service
  • Summersville, WV
National Provider Identifier
1659370856
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
020385 Issued in WV
Legal business name
NICHOLAS COMMUNITY ACTION PARTNERSHIP, INC.
Practice address
1205 Broad St
Summersville, WV 26651-1805
Phone
(304) 872-1162
Fax
(304) 872-5796
NPI assigned
Jul 19, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David A Jarroll
Title
President
Phone
(304) 872-1162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 020385 WV Primary

Addresses

Primary practice location

1205 Broad St
Summersville, WV 26651-1805

Mailing address

1205 Broad St
Summersville, WV 26651-1805
Phone (304) 872-1162

Other identifiers 2

IdentifierTypeStateIssuer
0030701000MedicaidWV
0030701001MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Nicholas Community Action Partnership Inc4 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.

Locations

1205 Broad St
Summersville, WV 26651
Phone (304) 872-1162

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659370856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 BROAD ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511805",
            "telephone_number": "304-872-1162",
            "fax_number": "304-872-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 BROAD ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511805",
            "telephone_number": "304-872-1162",
            "fax_number": "304-872-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS COMMUNITY ACTION PARTNERSHIP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JARROLL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-872-1162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WV",
            "license": "020385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030701000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030701001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summersville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.