NPIMap

Organization Active NPI

Community Health Association

Doing business as Jackson General Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Ripley, WV
National Provider Identifier
1083805790
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
52 Issued in WV
Legal business name
COMMUNITY HEALTH ASSOCIATION
Doing business as
Jackson General Hospital
Practice address
122 Pinnell St
Ripley, WV 25271-9101
Phone
(304) 372-2731
Fax
(304) 372-2749
NPI assigned
Aug 7, 2007
Last updated
Oct 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Stephanie L McCoy
Title
Chief Executive Officer
Phone
(304) 372-2731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 52 WV Primary

Addresses

Primary practice location

122 Pinnell St
Ripley, WV 25271-9101

Mailing address

122 Pinnell St
Ripley, WV 25271-9101
Phone (304) 372-2731

Other identifiers 2

IdentifierTypeStateIssuer
0001320007MedicaidWV
3810023822MedicaidWV

Other names 1

  • Jackson General Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220825001080 WV Part A Provider - Critical Access Hospital 1759291313 Practice locations: Ripley, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083805790. Details of each certification follow.

Hospital certification: CCN 51Z320

Legal name
COMMUNITY HEALTH ASSOCIATION
Doing business as
JACKSON GENERAL HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
122 Pinnell St
Ripley, WV 25271-9101
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

124 Pinnell St
Ripley, WV 25271
Phone (304) 373-0133

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Sarah Brown Individual Corporate Director May 27, 2014
Frederick W Parsons Individual Corporate Director May 27, 2014
John Gorrell Individual Corporate Director May 23, 2006
Dewey Clayton Individual W-2 Managing Employee Dec 8, 2018
Carl Westfall Individual Corporate Director Mar 1, 2017
Rodney Felty Individual Corporate Director Apr 28, 2020
Donald Keith Rake Individual Corporate Director Mar 25, 2003
Stephanie McCoy Individual W-2 Managing Employee Jan 3, 2011
Deborah Burge Individual Corporate Director Oct 24, 2018
Michael Ritchie Individual Corporate Director Mar 22, 2011
Carl L Overmiller Individual Corporate Director Mar 25, 2003
Jamion Wolford Individual Corporate Director Aug 15, 1985
James Hunter Individual Corporate Director Mar 28, 2006
West Virginia United Health System, Inc Organization, Morgantown, WV Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2019 100%
Carolyn Rader Individual Corporate Director Mar 1, 2017
James T. Hughes Individual Corporate Director Mar 27, 2001
Rebecca Scarberry Individual Corporate Director Jan 3, 2011
Brenda G Greene Individual W-2 Managing Employee Mar 29, 2011
Robert Fisher Individual Corporate Director Mar 23, 2004
Carroll Lee Corder Individual Corporate Director Jan 3, 2011
Michael Casdorph Individual Corporate Director Oct 24, 2018
West Virginia University Hospitals Inc Organization, Morgantown, WV Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 2019 100%

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 52

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 52

Practitioners & affiliated clinicians

Practitioners 118

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 118

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1083805790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 PINNELL ST",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252719101",
            "telephone_number": "304-372-2731",
            "fax_number": "304-372-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 PINNELL ST",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252719101",
            "telephone_number": "304-372-2731",
            "fax_number": "304-372-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "304-372-2731"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "WV",
            "license": "52",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001320007",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023822",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ripley, WV

Sources for this page

Verify at the official NPI Registry.