{"npi":"1811366248","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":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"167 GAWTHROP RD","city":"BUCKHANNON","state":"WV","postal_code":"262013927","country_code":"US","phone":"3044735690","fax":"3044735692"},{"purpose":"MAILING","street_1":"PO BOX 217","city":"ROCK CAVE","state":"WV","postal_code":"262340217","country_code":"US","phone":"3049246262","fax":"3049245460"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"2468-5535","state":"WV","issuer":"WV STATE TAX DEPT"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20151015001629","type_code":"00-04","type_desc":"PART A PROVIDER - FEDERALLY QUALIFIED HEALTH CENTER (FQHC)","state":"WV","pac_id":"0446232987"}]},"enumeration_date":"2015-09-16","last_updated":"2024-09-06","_meta":{"source":"NPPES","snapshot_date":"2024-09-06","doc_url":"https://findmynpi.com/api"}}