NPIMap

Organization Active NPI

Mountain Empire Older Citizens, Inc.

  • Community Based Hospice Care Agency
  • Big Stone Gap, VA
National Provider Identifier
1972534659
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MOUNTAIN EMPIRE OLDER CITIZENS, INC.
Practice address
1501 Third Avenue East
Big Stone Gap, VA 24219-3114
Phone
(276) 523-4202
Fax
(276) 523-4208
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Michael K Pease
Title
Executive Director
Phone
(276) 523-4202

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X VA Primary
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

1501 Third Avenue East
Big Stone Gap, VA 24219-3114

Mailing address

1520 3Rd Ave E
P. O. Box 888
Big Stone Gap, VA 24219-3114
Phone (276) 523-4202

Other identifiers 6

IdentifierTypeStateIssuer
009105077MedicaidVA
008700192MedicaidVA
008740259MedicaidVA
008770042MedicaidVA
010179238MedicaidVA
008730857MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Mountain Empire Older Citizens 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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972534659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 3RD AVE E",
            "address_2": "P. O. BOX 888",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193114",
            "telephone_number": "276-523-4202",
            "fax_number": "276-523-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 THIRD AVENUE EAST",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193114",
            "telephone_number": "276-523-4202",
            "fax_number": "276-523-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN EMPIRE OLDER CITIZENS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-07-21",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "PEASE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "276-523-4202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009105077",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008700192",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008740259",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008770042",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010179238",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008730857",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Stone Gap, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.