NPIMap

Organization Active NPI

Mercer County Commission on Aging, Inc.

  • PACE Provider Organization
  • Princeton, WV
National Provider Identifier
1972726099
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
License
251E00000X Issued in WV
Legal business name
MERCER COUNTY COMMISSION ON AGING, INC.
Practice address
600 Trent St.
Princeton, WV 24740-1507
Phone
(304) 425-7111
Fax
(304) 487-8801
NPI assigned
Apr 10, 2007
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
Mrs. Betty J. Whittaker
Title
Assistant Program Director
Phone
(304) 425-7111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X 251E00000X WV Primary

Addresses

Primary practice location

600 Trent St.
Princeton, WV 24740-1507

Mailing address

PO Box 1507
Princeton, WV 24740-1507
Phone (304) 425-7111

Other identifiers 2

IdentifierTypeStateIssuer
0030667000MedicaidWV
0030667001MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Mercer County Commission on Aging Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972726099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1507",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247401507",
            "telephone_number": "304-425-7111",
            "fax_number": "304-487-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 TRENT ST.",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247401507",
            "telephone_number": "304-425-7111",
            "fax_number": "304-487-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCER COUNTY COMMISSION ON AGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITTAKER",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "ASSISTANT PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "304-425-7111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "WV",
            "license": "251E00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030667000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030667001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, 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.