COMMUNITY CARE OF BRIDGEPORT
NPI 1144811290
Community/Behavioral Health in Bridgeport, WV

Active since February 01, 2021
65 PROFESSIONAL PL STE 101, BRIDGEPORT, WV 26330(304) 848-5770(304) 848-0890 Get Directions Write a Review

NPPES record last updated: February 17, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 17, 2021, Feb 1, 2021 (2 updates tracked since 2021).

About Community Care Of Bridgeport NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COMMUNITY CARE OF BRIDGEPORT (NPI 1144811290) is a healthcare organization registered as a community/behavioral health in Bridgeport, West Virginia and active in the NPI registry since February 2021. The organization maintains 15 additional practice locations and lists Dora L Potasnik, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1144811290
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameCOMMUNITY CARE OF WEST VIRGINIA, INC.
Location Address65 PROFESSIONAL PL STE 101Bridgeport, WV 26330-1889
Mailing Address65 Professional Pl Ste 101Bridgeport, WV 26330-1889 · (304) 848-5770 · Fax (304) 848-0890
Fax(304) 848-0890
Organization SubpartNo
Authorized OfficialDora L PotasnikCredentialing Coordinator · (304) 317-7275
Enumeration DateFebruary 1, 2021
Last NPPES UpdateFebruary 17, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2021
✔ NPI 1144811290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
65 PROFESSIONAL PL STE 101, Bridgeport, WV 26330

Other Names 1

Doing Business AsCommunity Care Of Bridgeport

Secondary Practice Locations 15

Location 1597 Liberty StWest Milford, WV 26451-6801 · Phone (304) 745-4568 · Fax (304) 326-3700
Location 237 W Main StBuckhannon, WV 26201-2235 · Phone (304) 473-5600 · Fax (304) 372-1341
Location 34498 Potomac Highlands TrailGreen Bank, WV 24944 · Phone (304) 456-5115 · Fax (304) 456-5118
Location 4100 S. Pickens RdHelvetia, WV 26224 · Phone (304) 924-5453 · Fax (304) 924-5496
Location 54 Northridge Dr Ste 118Buckhannon, WV 26201-8484 · Phone (304) 473-1440 · Fax (304) 473-1441
Location 6266 Skidmore LnSutton, WV 26601-9271 · Phone (304) 765-0351 · Fax (304) 765-7019
Location 7821 3rd AveMarlinton, WV 24954-1015 · Phone (304) 799-4404 · Fax (304) 799-4425
Location 8122 Center StClay, WV 25043-7046 · Phone (304) 587-7301 · Fax (304) 587-2464
Location 9797 Clinic DrIvydale, WV 25113-8263 · Phone (304) 286-4200 · Fax (304) 286-2107
Location 10149 Staunton DrWeston, WV 26452-5604 · Phone (304) 269-5510 · Fax (304) 269-2037
Location 11107 Staunton DrWeston, WV 26452-5604 · Phone (304) 269-2022 · Fax (304) 269-2037
Location 12700 Oakmound RdClarksburg, WV 26301-9398 · Phone (304) 623-6330 · Fax (304) 623-6220
Location 1334 N Kanawha StBuckhannon, WV 26201-2714 · Phone (304) 473-2250 · Fax (304) 924-5460
Location 14273 Skidmore LnSutton, WV 26601-9272 · Phone (304) 765-4400 · Fax (304) 765-0354
Location 1578 Queens Alley RdRock Cave, WV 26234-5890 · Phone (304) 924-6262 · Fax (304) 924-5460

Other Identifiers 1

Other516WV · State Of Wv Department Of Health And Human Services Behavioral Health License

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Community Care Of Bridgeport is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateWest VirginiaEnrollment IDO20210331002097Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Community Care Of Bridgeport, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Clinical Psychologist
NPI 1770080186
65 PROFESSIONAL PL STE 102103
Bridgeport, WV 26330
(304) 848-5770
✔ PECOSSame address
Psychiatry
NPI 1144664863
65 PROFESSIONAL PL STE 101
Bridgeport, WV 26330
(304) 848-5770
✔ PECOSSame address
Clinical Social Worker
NPI 1649539396
65 PROFESSIONAL PL STE 102103
Bridgeport, WV 26330
(304) 848-5770
✔ PECOSSame address
Clinical Social Worker
NPI 1235287798
65 PROFESSIONAL PL STE 102103
Bridgeport, WV 26330
(304) 848-5770
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Community Care Of West Virginia, Inc.'s NPI number?

The NPI number for Community Care Of West Virginia, Inc. is 1144811290. It was assigned to this organization in the NPPES registry on February 1, 2021. The provider is doing business as Community Care Of Bridgeport.

Where is Community Care Of West Virginia, Inc. located?

Community Care Of West Virginia, Inc. is located at 65 Professional Pl Ste 101, Bridgeport, WV 26330. The listed phone number is (304) 848-5770.

What is Community Care Of West Virginia, Inc.'s specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Community Care Of West Virginia, Inc. enrolled in Medicare?

Yes. Community Care Of West Virginia, Inc. is registered in the Medicare PECOS enrollment system.

When is Community Care Of West Virginia, Inc.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (West Virginia, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Community Care Of West Virginia, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Community Care Of West Virginia, Inc., in Clinical Psychologist, Clinical Social Worker and Psychiatry. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Community Care Of West Virginia, Inc. was last updated on February 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.