NPIMap

Organization Active NPI

Valley Health Systems Inc

  • Clinical Medical Laboratory
  • Huntington, WV
National Provider Identifier
1023083854
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
VALLEY HEALTH SYSTEMS INC
Practice address
307 5TH Ave
Huntington, WV 25702
Phone
(304) 525-0573
NPI assigned
Feb 23, 2006
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary-Beth Brubeck
Title
Vice President of Finance / Cfo
Phone
(304) 525-3334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

307 5TH Ave
Huntington, WV 25702

Mailing address

2585 3Rd Ave
Huntington, WV 25703-1642
Phone (304) 697-1396

Other identifiers 7

IdentifierTypeStateIssuer
CJ2698OtherWVRR MEDICARE GROUP
000391352OtherWVMT. STATE BC/BS
016OtherWVTRICARE
0039941000MedicaidWV
00058430OtherWVRR MEDICARE
3790386100MedicaidKY
000000178751OtherWVANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071024000038 WV Part B Supplier - Independent Clinical Laboratory 9931017969 Practice locations: Huntington, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D0952340Valley Health Diagnostics307 5TH Avenue G, Huntington, WV 25702AccreditationApr 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
Carl Johnson Medical Ce91 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

307 5th Ave
Huntington, WV 25702
Phone (304) 525-0573

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Valley Health Apple GroveApple Grove, WV, CCN 581056 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 16, 1975
Valley Health SCP - Charleston 108Charleston, WV, CCN 581062 Federally qualified health center Operational/Managerial Control Feb 1, 2024

Practitioners & affiliated clinicians

Practitioners 141

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 141

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1023083854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031642",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 5TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25702",
            "telephone_number": "304-525-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "BRUBECK",
        "authorized_official_first_name": "MARY-BETH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE / CFO",
        "authorized_official_telephone_number": "304-525-3334"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CJ2698",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT. STATE BC/BS",
            "identifier": "000391352",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "016",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0039941000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "00058430",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3790386100",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000178751",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.