NPIMap

Organization Active NPI

Southwest Virginia Community Health Systems Inc

Doing business as Marion MAT

  • Federally Qualified Health Center (FQHC)
  • Marion, VA
National Provider Identifier
1073164539
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC
Doing business as
Marion MAT
Practice address
416 E Main St RM 2
Marion, VA 24354-3318
Phone
(276) 783-8185
NPI assigned
Sep 26, 2019
Last updated
Jun 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Authorized official

Name
Joseph Bryan Haynes
Title
Ceo
Phone
(276) 496-4492

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

416 E Main St RM 2
Marion, VA 24354-3318

Mailing address

PO Box 297
Meadowview, VA 24361-0297
Phone (276) 496-4492

Other names 1

  • Marion MAT Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000290 VA Part B Supplier - Clinic/Group Practice 4880502707 Receives reassigned benefits from 33 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tazewell, VA; Saltville, VA; Meadowview, VA; Chilhowie, VA; Bristol, VA

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Locations

416 E Main St
Rm 2
Marion, VA 24354
Phone (276) 783-8185

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1073164539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "MEADOWVIEW",
            "state": "VA",
            "postal_code": "243610297",
            "telephone_number": "276-496-4492",
            "fax_number": "276-695-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E MAIN ST RM 2",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243543318",
            "telephone_number": "276-783-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "276-496-4492"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion MAT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.