NPIMap

Organization Active NPI

Stonewall Jackson Memorial Hospital

Doing business as Stonewall Jackson Home Care

  • Home Health Agency
  • Weston, WV
National Provider Identifier
1083617989
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
STONEWALL JACKSON MEMORIAL HOSPITAL
Doing business as
Stonewall Jackson Home Care
Practice address
456 Suite B Market Place Mall
Weston, WV 26452-6938
Phone
(304) 269-4556
Fax
(304) 269-4559
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
Mrs. M. Jane Eisenbeis, RN
Title
Director of External Operations
Phone
(304) 269-4556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X WV Primary

Addresses

Primary practice location

456 Suite B Market Place Mall
Weston, WV 26452-6938

Mailing address

456 Suite B Market Place Mall
Weston, WV 26452-6938
Phone (304) 269-4556

Other identifiers 3

IdentifierTypeStateIssuer
WV22958AOtherWVHEALTH PLAN
300699OtherWVFEDERAL BLACK LUNG
0001417001MedicaidWV

Other names 1

  • STONEWALL JACKSON HOME CARE Doing business as

National Provider Directory

National Provider Directory

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": "1083617989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 SUITE B MARKET PLACE MALL",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264526938",
            "telephone_number": "304-269-4556",
            "fax_number": "304-269-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 SUITE B MARKET PLACE MALL",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264526938",
            "telephone_number": "304-269-4556",
            "fax_number": "304-269-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEWALL JACKSON MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "EISENBEIS",
        "authorized_official_first_name": "M.",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "DIRECTOR OF EXTERNAL OPERATIONS",
        "authorized_official_telephone_number": "304-269-4556",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN",
            "identifier": "WV22958A",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "300699",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001417001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STONEWALL JACKSON HOME CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.