NPIMap

Organization Active NPI

Valley Health Systems, Inc.

Doing business as Ft. Gay Health Care

  • Dentist
  • Fort Gay, WV
National Provider Identifier
1104099811
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2768 Issued in WV
Legal business name
VALLEY HEALTH SYSTEMS, INC.
Doing business as
Ft. Gay Health Care
Practice address
#71 Wayne St
Fort Gay, WV 25514-8518
Phone
(304) 648-5544
NPI assigned
Apr 3, 2008
Last updated
Feb 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Mary-Beth Brubeck
Title
Vice President of Finance / Cfo
Phone
(304) 525-3334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2768 WV Primary

Addresses

Primary practice location

#71 Wayne St
Fort Gay, WV 25514-8518

Mailing address

PO Box 1680
Huntington, WV 25717-1680
Phone (304) 697-1396

Other identifiers 3

IdentifierTypeStateIssuer
2752543MedicaidOH
0035071001MedicaidWV
6190084100MedicaidKY

Other names 1

  • Ft. Gay Health Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carl Johnson Medical Ce91 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1104099811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#71 WAYNE ST",
            "city": "FORT GAY",
            "state": "WV",
            "postal_code": "255148518",
            "telephone_number": "304-648-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "BRUBECK",
        "authorized_official_first_name": "MARY-BETH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE / CFO",
        "authorized_official_telephone_number": "304-525-3334"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "2768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2752543",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035071001",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6190084100",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ft. Gay Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ft. Gay Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Gay, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.