NPIMap

Organization Active NPI

Princeton Community Hospital Assn Inc.

  • Urology Physician
  • Princeton, WV
National Provider Identifier
1093917643
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
10308 Issued in WV
Legal business name
PRINCETON COMMUNITY HOSPITAL ASSN INC.
Practice address
118 12TH Street
Princeton, WV 24740
Phone
(304) 487-7936
Fax
(304) 487-7835
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Diane Lynn Spencer
Title
VP of Finance/Cfo
Phone
(304) 487-7505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X 10308 WV Primary

Addresses

Primary practice location

118 12TH Street
Princeton, WV 24740

Mailing address

118 12TH Street
Princeton, WV 24740
Phone (304) 487-7936

Other names 1

  • MERCER MEDICAL GROUP Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031211000436 WV Part B Supplier - Clinic/Group Practice 3678482221 Receives reassigned benefits from 298 practitioners
1 other NPI on this enrollment
Practice locations: Athens, WV; Princeton, WV; Bluefield, WV

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Member organizations 8

Organizations listed as members of this organization in the National Provider Directory.

Locations

1331 Southview Dr
Ste 2
Bluefield, WV 24701
Phone (304) 327-2410

510 Cherry St
Ste 101A
Bluefield, WV 24701

510 Cherry St
Ste 206A
Bluefield, WV 24701

185 Laurel Creek Rd
Fayetteville, WV 25840
Phone (304) 574-0294

150 Courthouse Rd
Ste 101D
Princeton, WV 24740
Phone (304) 425-7127

296 New Hope Rd
Ste 2
Princeton, WV 24740
Phone (304) 425-0345

122 12th St
Ste B
Princeton, WV 24740
Phone (304) 325-1982

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
PCH Home HealthPrinceton, WV, CCN 517081A Home health agency 5% Or Greater Direct Ownership Interest (33%) May 1, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 372

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 372

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1093917643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 12TH STREET",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "24740",
            "telephone_number": "304-487-7936",
            "fax_number": "304-487-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 12TH STREET",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "24740",
            "telephone_number": "304-487-7936",
            "fax_number": "304-487-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON COMMUNITY HOSPITAL ASSN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP OF FINANCE/CFO",
        "authorized_official_telephone_number": "304-487-7505"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "WV",
            "license": "10308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MERCER MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MERCER MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.