Organization Active NPI

Ohio Valley Physicians, Inc

  • Rural Health Clinic/Center
  • Logan, WV
National Provider Identifier
1104220409
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
OHIO VALLEY PHYSICIANS, INC
Practice address
557 Main St
Logan, WV 25601-3809
Phone
(740) 752-3435
Fax
(740) 753-3436
NPI assigned
Oct 15, 2014
Organization subpart
Yes
Parent organization
OHIO VALLEY PHYSICIANS, INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Ashley Endlich
Title
Credentialing Specialist
Phone
(304) 429-1088

Owners & managing parties with NPI records 3

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

Other NPIs with the same Medicare PAC ID 9

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

Practitioners 130

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

View all 130

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2091379Ovp Health557 Main Street, Logan, WV 25601Certificate of waiverFeb 11, 2027

Medicare participation

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

Rural health clinic certification: CCN 513922

Medicare enrollment files
Legal name
OHIO VALLEY PHYSICIANS INC
Doing business as
OVP HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 22, 2019
Last certification
Apr 23, 2024
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Apr 11, 2001 in WV
Enrollment address
557 Main St
Logan, WV 25601-3809

All disclosed owners & managing parties 4

Medicare enrollment files

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

NameRoleSinceShare
Stacey C Shy Individual Corporate OfficerCeo Apr 1, 2006
W-2 Managing EmployeeCeo Apr 1, 2006
Robert a Hess Individual 5% Or Greater Direct Ownership Interest Jul 1, 1999 45%
Corporate OfficerPresident Jul 1, 1999 45%
Operational/Managerial ControlPresident Jul 1, 1999 45%
Stephen C Shy Individual 5% Or Greater Direct Ownership InterestOfficer Jul 1, 2018 50%
Corporate OfficerOfficer Mar 1, 2019
Operational/Managerial Control Mar 1, 2019
Jonathan a Hess Individual 5% Or Greater Direct Ownership Interest Jan 1, 2016 5%
Corporate OfficerSecretary Jan 1, 2016 5%
Operational/Managerial ControlSecretary Jan 1, 2016 5%

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20190509002419 WV Part a Provider - Rural Health Clinic 8729032966 Practice locations: Logan, WV

National Provider Directory

National Provider Directory
Part of
Ohio Valley Physicians

Locations

141 E 2nd Ave
Williamson, WV 25661
Phone (304) 235-9781

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

NPPES NPI Registry

Primary practice location

557 Main St
Logan, WV 25601-3809

Mailing address

PO Box 390
Huntington, WV 25708-0390
Phone (304) 752-3435

Other names 1

NPPES NPI Registry
  • OVP Health Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2024.

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1104220409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257080390",
            "telephone_number": "304-752-3435",
            "fax_number": "304-752-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 MAIN ST",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013809",
            "telephone_number": "740-752-3435",
            "fax_number": "740-753-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO VALLEY PHYSICIANS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OHIO VALLEY PHYSICIANS, INC",
        "enumeration_date": "2014-10-15",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "ENDLICH",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "304-429-1088"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OVP Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logan, WV

Sources for this page

Verify at the official NPI Registry.