Valley Health Systems, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Charleston, WV
NPI 1013577303 · NPPES record last updated Jun 18, 2019
Key facts
- NPI
- 1013577303
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- VALLEY HEALTH SYSTEMS, INC.
- Practice address
- 864 Oakwood Rd
Charleston, WV 25314-2010 - Phone
- (304) 343-2807
- Fax
- (304) 525-3338
- NPI assigned
- Jun 18, 2019
- Organization subpart
- No
Authorized official
- Name
- Mary-Beth Brubeck
- Title
- Cfo
- Phone
- (304) 525-3334
Owners & managing parties with NPI records 1
Practitioners 48
-
Sierra Michele Adkins, FNP-BC
-
Michael Amos, MD
-
John David Apgar, DO
-
Jason Ashworth, APRN-FNP-C
-
Katelyn Jo Aubry, FNP-BC
-
Jessica Dawn Auffant, NP-C
-
Shelley Bailey, MD
-
Brandi Jay Blake, FNP-BC
-
Ryan R Cicenas, MD
-
Alexandra Nicole Collins, MSN, APRN, FNP-BC
-
Scott Edward Davis, M.D.
-
Bridgett Freeman, FNP
-
Lissa L Gonzalez, CRNP
-
Jenifer Hadley, D.O.
-
Jessica Leigh Holley, APRN
-
Kathy Jo Kirby, APRN, FNP-BC
-
Olivia Legg, APRN, NP-C
-
Leigh Ann Levine, DO
-
Jeremy McDaniel, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
Federally qualified health center certification: CCN 511176
- Legal name
- VALLEY HEALTH SYSTEMS, INC
- Doing business as
- VALLEY HEALTH OAKWOOD ROAD
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 24, 2019
- Last certification
- Oct 24, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 23, 2019 in WV
- Enrollment address
- 864 Oakwood Rd
Charleston, WV 25314-2010
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Sherry Perry |
Other |
Oct 23, 2019 | |
| Christina Walter |
Corporate Director |
Apr 25, 2019 | |
| Jared Colker |
Other |
Oct 23, 2019 | |
| Paulette Mabry |
Other |
Oct 23, 2019 | |
| Bill Bryant |
Other |
Oct 23, 2019 | |
| Suzi Brodof |
Other |
Oct 23, 2019 | |
| Mathew Weimer |
Corporate Officer |
Sep 28, 2024 | |
| W-2 Managing Employee | Sep 28, 2024 | ||
| Sherrone Hornbuckle |
Other |
Oct 23, 2019 | |
| Mary-Beth Brubeck |
Corporate Officer |
Oct 23, 2019 | |
| W-2 Managing Employee |
Oct 23, 2019 | ||
| Kalyn Obiozor Dorey |
Corporate Director |
Nov 22, 2022 | |
| Greg Agee |
Other |
Oct 23, 2019 | |
| Jill Hutchinson |
Other |
Oct 23, 2019 | |
| Benjamin L Howard |
Other |
Oct 23, 2019 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Valley Health Apple Grove |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 16, 1975 |
| Valley Health SCP - Charleston 108 |
Federally qualified health center | Operational/Managerial Control | Feb 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191206002391 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 9931017969 | Practice locations: Charleston, WV |
| O20200407002573 | WV | Part B Supplier - Clinic/Group Practice | 9931017969 |
Receives reassigned benefits from 45 practitioners Practice locations: Charleston, WV |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
864 Oakwood Rd
Charleston, WV 25314-2010
Mailing address
2585 3Rd Ave
Huntington, WV 25703-1642
Phone (304) 697-1396
Other names
- Valley Health Oakwood Road
Other providers in Charleston, WV
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- Valley Health Systems, Inc.
- Valley Heart and Vascular Associates PLLC
- Valley Pharmacy Solutions LLC
- Teresa A Van Alstyne
- Jason Van Beveren
All providers in Charleston, WV · Federally Qualified Health Center (FQHC) in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.