CHANGE INCORPORATED (NPI# 1063918472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063918472 |
| Entity Type | Organization |
| Organization Name | CHANGE INCORPORATED |
| Other Organization Name | FMC SBHC - BROOKE COMPLEX |
| Practice Address |
29 Bruin Dr Wellsburg WV 26070-3064 |
| Mailing Address |
3158 West St Weirton WV 26062-4637 |
| Practice Telephone | 0479777333 |
| Mailing Telephone | 1304797773 |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |
| Authorized Official Name | JUDY L RAVEAUX (CEO) |
| Authorized Official Telephone | 3047977733 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHANGE INCORPORATED |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
2271-6959 | WV | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| FMC SBHC - Brooke Complex | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174074686 | Change Incorporated | Clinic/Center | 1151 Washington St, Newell, WV 26050 | 2016-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Change Incorporated | 1251 South Main Street, Middletown, CT 06457 |
| Street Address |
29 BRUIN DR |
| City | WELLSBURG |
| State | WV |
| Zip Code | 26070-3064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942840939 | Elissa Michelle Caprini | Speech-Language Pathologist | 29 Bruin Dr, Wellsburg, WV 26070-3064 | 2020-01-08 |
| 1578101846 | Jenna Broda | Speech-Language Pathologist | 29 Bruin Dr, Wellsburg, WV 26070-3064 | 2019-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073096913 | Chelsea M Camerlengo | Physician Assistant | 1006 Commerce Street, Wellsburg, WV 26070 | 2018-09-06 |
| 1538665948 | Pamela Sue Lizon | Pharmacist | 1612 Main Street, Wellsburg, WV 26070 | 2018-04-04 |
| 1336151315 | Brooke County Commission | Ambulance | 54 Marshall Street, Wellsburg, WV 26070 | 2006-08-11 |
| 1184629404 | Amy Elizabeth Butts | Physician Assistant | 1423 Commerce Street, Wellsburg, WV 26070 | 2005-06-14 |
| 1700331360 | Loretta Lynn Sanchez | Case Manager/Care Coordinator | 2241 Main St, Wellsburg, WV 26070-1035 | 2016-08-23 |
| 1760416556 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 91 27th St, Wellsburg, WV 26070-1161 | 2006-07-10 |
| 1659726354 | Lisa Machelle Velegol | Pharmacist | 91 27th St, Wellsburg, WV 26070-1161 | 2016-04-30 |
| 1578918835 | Thomas David Faulstick | Pharmacist | 91 27th St, Wellsburg, WV 26070-1161 | 2016-04-24 |
| 1548549660 | Ross Andrew Tennant IIi | Registered Nurse | 2140 Pleasant Ave, Wellsburg, WV 26070-1244 | 2011-08-07 |
| 1912272931 | Wheeling Hospital, Inc. | Internal Medicine | 1423 Commerce St, Wellsburg, WV 26070-1320 | 2012-03-09 |
| Find all providers in zip 26070 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1801493499 | Camden On Gauley Medical Center Inc | Clinic/Center | 52 Florence Street, Ansted, WV 25812 | 2020-10-06 |
| 1194339309 | Community Care of West Virginia, Inc. | Clinic/Center | 33 E Victoria St, Buckhannon, WV 26201-2671 | 2020-09-04 |
| 1063048189 | Community Care of West Virginia, Inc. | Clinic/Center | 34 N Kanawha St, Buckhannon, WV 26201-2714 | 2020-03-20 |
| 1619503422 | Change Inc | Clinic/Center | 114 Taylor Ave, Weirton, WV 26062-4635 | 2020-03-13 |
| 1861023699 | Logan-mingo Area Mental Health, Inc | Clinic/Center | 2954 Buffalo Creek Road, Chattaroy, WV 25667 | 2020-01-30 |
| 1689220402 | New River Health Association, Inc. | Clinic/Center | 2 Greyhound Ln., Smithers, WV 25186 | 2019-08-16 |
| 1740836873 | Williamson Health & Wellness Center Inc | Clinic/Center | 5 Parkway Dr, Williamson, WV 25661-3428 | 2019-08-14 |
| 1699321729 | Williamson Health & Wellness Center Inc | Clinic/Center | 50 Panther Blvd, Williamson, WV 25661-7441 | 2019-08-14 |
| 1083260129 | Williamson Health & Wellness Center Inc | Clinic/Center | 300 Blue Devil Lane, Kermit, WV 25661 | 2019-08-14 |
| 1225684731 | Williamson Health & Wellness Center Inc | Clinic/Center | 1000 King Coal Hwy, Delbarton, WV 25670-9529 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.