NPIMap

Organization Active NPI

Shenandoah Valley Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Martinsburg, WV
National Provider Identifier
1083617823
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SHENANDOAH VALLEY MEDICAL SYSTEM, INC.
Practice address
99 Tavern Rd
Martinsburg, WV 25401-2890
Phone
(304) 263-4999
NPI assigned
May 24, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Michael Hassing
Title
Ceo
Phone
(304) 263-4999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X WV Primary

Addresses

Primary practice location

99 Tavern Rd
Martinsburg, WV 25401-2890

Mailing address

PO Box 1146
Martinsburg, WV 25402-2890
Phone (304) 263-4999

Other identifiers 1

IdentifierTypeStateIssuer
0035217000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20031119000556 WV Part B Supplier - Public Health/Welfare Agency 9739093097 Receives reassigned benefits from 34 practitioners
3 other NPIs on this enrollment
Practice locations: Berkeley Springs, WV; Charles Town, WV; Martinsburg, WV; Ranson, WV
O20050609000371 WV Part A Provider - Federally Qualified Health Center (FQHC) 9739093097 Practice locations: Martinsburg, WV
O20050613000473 VA Part B Supplier - Clinic/Group Practice 9739093097 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Winchester, VA
O20090312000099 WV Part A Provider - Federally Qualified Health Center (FQHC) 9739093097 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winchester, VA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1083617823. Details of each certification follow.

Federally qualified health center certification: CCN 511844

Legal name
SHENANDOAH VALLEY MEDICAL SYSTEM,INC.
Doing business as
SHENANDOAH COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1994
Last certification
Jul 1, 1994
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Apr 7, 1976 in WV
Enrollment address
99 Tavern Rd
Martinsburg, WV 25401-2890

Federally qualified health center certification: CCN 491840

Legal name
SHENANDOAH VALLEY MEDICAL SYSTEM,INC.
Doing business as
WINCHESTER FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 30, 1998
Last certification
Jun 30, 1998
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Apr 7, 1976 in WV
Enrollment address
1330 Amherst St
Winchester, VA 22601-3054
Related CCNs
511844

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Locations

44 Trifecta Pl
Ste 205
Charles Town, WV 25414
Phone 30426349991063

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Pamela Parsons Individual Corporate OfficerBoard Member Jun 3, 2024
Megan Holben Individual Corporate Officer Jul 1, 2024
Annley Nikki Bigiarelli Individual Corporate DirectorBoard of Directors Dec 5, 2022
Corporate DirectorBoard of Directors Dec 6, 2022
John Charlton Individual Corporate OfficerSecretary Apr 3, 2023
Harold Shrewsberry Individual Corporate OfficerChairman of the Board Apr 3, 2023
Frank S Coe Individual Corporate OfficerTreasurer Aug 1, 2002
Corporate OfficerTreasurer Jan 4, 2021
Jennifer Tolley Individual Corporate OfficerBoard Member Sep 5, 2023
Joseph Robinson Individual Corporate OfficerBoard Member Jun 3, 2024
Todd M Lockcuff Individual Corporate OfficerCeo Sep 1, 2025 100%
W-2 Managing EmployeeCeo Sep 1, 2025 100%
Zachary Leach Individual Corporate OfficerVice Chair Nov 6, 2023

Practitioners & affiliated clinicians

Practitioners 52

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 52

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1083617823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1146",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254022890",
            "telephone_number": "304-263-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 TAVERN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012890",
            "telephone_number": "304-263-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH VALLEY MEDICAL SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HASSING",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-263-4999"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035217000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.