NPIMap

Organization Active NPI

Mingo Care Center, Inc.

  • Nursing Facility/Intermediate Care Facility
  • Williamson, WV
National Provider Identifier
1730177130
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
92 Issued in WV
Legal business name
MINGO CARE CENTER, INC.
Practice address
100 Hillcrest Dr
Williamson, WV 25661-3948
Phone
(304) 235-7005
Fax
(304) 752-8768
NPI assigned
Oct 10, 2005
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. Thomas Sphatt
Title
Chief of Operations & Finance
Phone
(304) 752-8761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 92 WV Primary

Addresses

Primary practice location

100 Hillcrest Dr
Williamson, WV 25661-3948

Mailing address

100 Hillcrest Dr
Williamson, WV 25661-3948
Phone (304) 235-7005

Other identifiers 1

IdentifierTypeStateIssuer
0003991000MedicaidWV

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730177130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HILLCREST DR",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613948",
            "telephone_number": "304-235-7005",
            "fax_number": "304-752-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HILLCREST DR",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613948",
            "telephone_number": "304-235-7005",
            "fax_number": "304-752-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINGO CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPHATT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CHIEF OF OPERATIONS & FINANCE",
        "authorized_official_telephone_number": "304-752-8761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "WV",
            "license": "92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003991000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamson, 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.