NPIMap

Organization Active NPI

East Mountain Health Physicians Inc

Doing business as Valley Health Multispecialty Clinic Charles Town

  • Obstetrics & Gynecology Physician
  • Charles Town, WV
National Provider Identifier
1073024923
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
EAST MOUNTAIN HEALTH PHYSICIANS INC
Doing business as
Valley Health Multispecialty Clinic Charles Town
Practice address
710 Somerset Blvd Ste 100
Charles Town, WV 25414-4998
Phone
(304) 724-7200
NPI assigned
Oct 18, 2017
Organization subpart
Yes
Parent organization
EAST MOUNTAIN HEALTH PHYSICIANS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Authorized official

Name
Renee Nevada Johnson
Title
Coordinator Insurance Credentialing
Phone
(540) 536-0103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

710 Somerset Blvd Ste 100
Charles Town, WV 25414-4998

Mailing address

220 Campus Blvd Ste 200
Winchester, VA 22601-2889
Phone (540) 536-0231

Other names 1

  • Valley Health Multispecialty Clinic Charles Town Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170425001245 WV Part B Supplier - Clinic/Group Practice 9133405327 Receives reassigned benefits from 160 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ranson, WV; Hedgesville, WV; Martinsburg, WV; Inwood, WV; Baker, WV

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Part of
East Mountain HLTH Phys Inc

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1073024923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 200",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012889",
            "telephone_number": "540-536-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 SOMERSET BLVD STE 100",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144998",
            "telephone_number": "304-724-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST MOUNTAIN HEALTH PHYSICIANS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST MOUNTAIN HEALTH PHYSICIANS, INC.",
        "enumeration_date": "2017-10-18",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "NEVADA",
        "authorized_official_title_or_position": "COORDINATOR INSURANCE CREDENTIALING",
        "authorized_official_telephone_number": "540-536-0103"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Multispecialty Clinic Charles Town",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charles Town, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.