{"npi":"1093765869","type":"NPI-2","status":"active","name":{"display":"Community Care Of West Virginia, Inc.","other":[],"organization_name":"COMMUNITY CARE OF WEST VIRGINIA, INC.","authorised_official":"Dora Potasnik"},"specialty":{"primary_taxonomy":"261QF0400X","primary_taxonomy_description":"Federally Qualified Health Center","slug":"fqhc","schema_org_specialty":"PrimaryCare","all":[{"code":"261QF0400X","description":"Federally Qualified Health Center","primary":true,"state":"WV","license":"2267-0579"}]},"addresses":[{"purpose":"LOCATION","street_1":"236 CHURCH ST","city":"CLAY","state":"WV","postal_code":"250439412","country_code":"US","phone":"3045874375","fax":"3045874375"},{"purpose":"MAILING","street_1":"PO BOX 147","city":"CLAY","state":"WV","postal_code":"250430147","country_code":"US","phone":"3045877301","fax":"3045872594"}],"license":{"state":"WV","number":"2267-0579"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"0035189005","state":"WV","issuer":null},{"type_code":"01","label":"Other","value":"001979216","state":"WV","issuer":"MS BCBS"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20120831000422","type_code":"00-04","type_desc":"PART A PROVIDER - FEDERALLY QUALIFIED HEALTH CENTER (FQHC)","state":"WV","pac_id":"0446232987"}]},"enumeration_date":"2006-05-11","last_updated":"2013-02-06","_meta":{"source":"NPPES","snapshot_date":"2013-02-06","doc_url":"https://findmynpi.com/api"}}