NPIMap

Organization Active NPI

Rainelle Medical Center, Inc

Doing business as RMC Greenbrier Nephrology Center - Alleghany

  • Nephrology Physician
  • Covington, VA
National Provider Identifier
1174132153
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
RAINELLE MEDICAL CENTER, INC
Doing business as
RMC Greenbrier Nephrology Center - Alleghany
Practice address
117 Mall Rd
Covington, VA 24426-2413
Phone
(304) 438-6188
Fax
(304) 438-6819
NPI assigned
Jul 27, 2020
Last updated
Jul 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Authorized official

Name
Debra J Davidson-Bennett
Title
Credentialing Specialist
Phone
(304) 438-6188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

117 Mall Rd
Covington, VA 24426-2413

Mailing address

176 Medical Center Dr
Rainelle, WV 25962-1064
Phone (304) 438-6188

Other names 1

  • RMC GREENBRIER NEPHROLOGY CENTER - ALLEGHANY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201031000080 VA Part A Provider - Federally Qualified Health Center (FQHC) 7416861810 1 other NPI on this enrollment
Practice locations: Covington, VA
O20210630001870 VA Part B Supplier - Clinic/Group Practice 7416861810 Receives reassigned benefits from 3 practitioners
Practice locations: Covington, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174132153. Details of each certification follow.

Federally qualified health center certification: CCN 491974

Legal name
RAINELLE MEDICAL CENTER INC
Doing business as
RMC GREENBRIER NEPHROLOGY ALLEGHANY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 31, 2020
Last certification
Oct 31, 2020
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Nov 13, 1988 in WV
Enrollment address
117 Mall Rd
Covington, VA 24426-2413

Other NPIs with the same Medicare PAC ID 15

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

View all 15

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Richard Lohmeyer Individual Corporate DirectorBod Mar 1, 2012
Pamela Fitzwater Individual Corporate DirectorBod Jan 1, 2013
Davida Farley Individual Corporate DirectorBod Jan 1, 2006
Monica Venable Individual Corporate DirectorBod Jan 1, 2012
Kristi Atha-Rader Individual Corporate OfficerCeo Jun 30, 2008
Gary G Veronneau Individual Corporate DirectorBod Jan 1, 2013
Kimberly Howard Individual Corporate DirectorBod Jan 1, 2006
Ron Fleshman Individual Corporate DirectorBod Jan 1, 2006
Christopher Clay Individual W-2 Managing EmployeeCfo Dec 15, 2008
Rainelle Medical Center Inc Organization, Rainelle, WV Non-profit Operational/Managerial Control Jul 1, 2020
Frank Mullins Individual Corporate DirectorBod Jan 1, 2015
George Hall Individual Corporate DirectorBod Jan 1, 2006

Owners & managing parties with NPI records 16

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

View all 16

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Midland Trail Health CenterHico, WV, CCN 511152 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2018
Lewisburg Health CenterLewisburg, WV, CCN 511158 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2018
Rupert Health CenterRupert, WV, CCN 581046 Federally qualified health center Operational/Managerial Control (100%) Jun 26, 2024

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 59

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 59

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1174132153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 MEDICAL CENTER DR",
            "city": "RAINELLE",
            "state": "WV",
            "postal_code": "259621064",
            "telephone_number": "304-438-6188",
            "fax_number": "304-438-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MALL RD",
            "city": "COVINGTON",
            "state": "VA",
            "postal_code": "244262413",
            "telephone_number": "304-438-6188",
            "fax_number": "304-438-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINELLE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON-BENNETT",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "304-438-6188"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RMC GREENBRIER NEPHROLOGY CENTER - ALLEGHANY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, VA

Sources for this page

Verify at the official NPI Registry.