Revalidation record
Change Incorporated — revalidation due 2026-04-30
past duemay be staleNPI 1245244367 · Part A · WV · Enrollment ID O20140630001386
From the CMS revalidation file for October 2026, published 2026-10-01 · check this NPI in CMS’s own lookup ↗ ·
This NPI has 19 enrollments. They stay separate. The detail below is the one to look at first.
| Enrollment | State | Form | Due |
|---|---|---|---|
| O20140630001386 | WV | 855A | 2026-04-30 |
| O20190221001420 | WV | 855A | 2026-05-31 |
| O20190221002991 | WV | 855A | 2026-06-30 |
| O20200129003123 | OH | 855A | 2026-07-31 |
| O20200130001026 | OH | 855A | 2026-08-31 |
| O20200130001653 | OH | 855A | 2026-09-30 |
| O20211007000928 | WV | 855A | 2026-10-31 |
| O20211026002338 | WV | 855A | 2026-11-30 |
| O20211102003445 | WV | 855A | 2026-12-31 |
| O20050614001275 | WV | 855B | 2027-01-31 |
| O20200130002042 | OH | 855A | 2027-02-28 |
| O20061221000330 | WV | 855A | TBD |
| O20130304000156 | OH | 855B | TBD |
| O20200130002189 | OH | 855A | TBD |
| O20211021000470 | WV | 855A | TBD |
| O20160510000754 | WV | 855A | 2024-01-31 |
| O20180326002488 | WV | 855A | 2024-01-31 |
| O20130111000013 | OH | 855A | 2024-05-31 |
| O20181016000087 | OH | 855A | 2024-07-31 |
- Revalidation due
- 2026-04-30
- Form to file
- 855A
Institutional providers file CMS-855A.
CMS published a due date of 2026-04-30 (183 days ago). We cannot tell from the file whether you completed this.
CMS may deactivate billing privileges when a full and accurate application isn't received within 90 days (42 CFR 424.540(a)(3)). Claims are denied while deactivated. Reactivation is effective the day CMS receives your application — it is not retroactive.
What changed, month by month
| Snapshot | Due date on the CMS file |
|---|---|
| 2026-10 | 2026-04-30 |
Not an official CMS system. Verify before filing.
All WV revalidation dates for October 2026Where this date comes from