NPIMap

Organization Active NPI

Rescare

  • Intellectual Disabilities Intermediate Care Facility
  • Fairmont, WV
National Provider Identifier
1750446738
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
298 Issued in WV
Legal business name
RESCARE
Practice address
1542 Mary Lou Retton Dr
Fairmont, WV 26554-2225
Phone
(304) 366-4415
NPI assigned
Dec 27, 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
Kandi Shaffer
Title
Executive Director
Phone
(304) 225-4550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 298 WV Primary

Addresses

Primary practice location

1542 Mary Lou Retton Dr
Fairmont, WV 26554-2225

Mailing address

5000 Greenbag Road
Unit B-6
Morgantown, WV 26201
Phone (304) 225-4550

Other identifiers 1

IdentifierTypeStateIssuer
0005258026MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Rescare27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

1542 Mary Lou Retton Dr
Fairmont, WV 26554
Phone (304) 366-4415

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750446738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 GREENBAG ROAD",
            "address_2": "UNIT B-6",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26201",
            "telephone_number": "304-225-4550",
            "fax_number": "304-225-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 MARY LOU RETTON DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542225",
            "telephone_number": "304-366-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "KANDI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-225-4550"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "WV",
            "license": "298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005258026",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, 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.