NPIMap

Organization Active NPI

Potomac Comprehensive Diagnostic and Guidance Center Inc

Doing business as Potomac Center Inc Birch Lane Group Home

  • Intellectual Disabilities Intermediate Care Facility
  • Romney, WV
National Provider Identifier
1700961844
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
WVDHHR213 Issued in WV
Legal business name
POTOMAC COMPREHENSIVE DIAGNOSTIC AND GUIDANCE CENTER INC
Doing business as
Potomac Center Inc Birch Lane Group Home
Practice address
One Blue Street
Romney, WV 26757
Phone
(304) 822-3861
Fax
(304) 822-4297
NPI assigned
Oct 26, 2006
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 Plowright
Title
Executive Director
Phone
(304) 822-3861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X WVDHHR213 WV Primary

Addresses

Primary practice location

One Blue Street
Romney, WV 26757

Mailing address

One Blue Street
Romney, WV 26757
Phone (304) 822-3861

Other identifiers 1

IdentifierTypeStateIssuer
0003198001MedicaidWV

Other names 1

  • Potomac Center Inc Birch Lane Group Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Potomac Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700961844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE BLUE STREET",
            "city": "ROMNEY",
            "state": "WV",
            "postal_code": "26757",
            "telephone_number": "304-822-3861",
            "fax_number": "304-822-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE BLUE STREET",
            "city": "ROMNEY",
            "state": "WV",
            "postal_code": "26757",
            "telephone_number": "304-822-3861",
            "fax_number": "304-822-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC COMPREHENSIVE DIAGNOSTIC AND GUIDANCE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PLOWRIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-822-3861",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "WV",
            "license": "WVDHHR213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003198001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac Center Inc Birch Lane Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Romney, 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.