Charleston Medical Center, Inc.
Organization Active NPI General Acute Care Hospital · Fayetteville, WV
NPI 1174479513 · NPPES record last updated Sep 11, 2026
Key facts
- NPI
- 1174479513
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- CHARLESTON MEDICAL CENTER, INC.
- Practice address
- 211 W Maple Ave
Fayetteville, WV 25840-1445 - Phone
- (304) 900-5511
- NPI assigned
- Mar 9, 2026
- Organization subpart
- No
Authorized official
- Name
- Ginger Peters
- Title
- Payer Enrollment Representative
- Phone
- (304) 388-0112
Owners & managing parties with NPI records 3
-
James Campbell, M.D.
-
Glenn Crotty Jr., MD
-
Stefan Randolph Maxwell, M.D.
Other NPIs on the same Medicare enrollment 14
Corporate family (same tax ID) 28
Related certifications (CCN) 3
Affiliated clinicians 1,621
-
Adham Abou Ali, M.D.
-
Ali F Aburahma, M.D.
-
Jason Dean Adams, MD
-
Mary Hunter Adams, FNPC
-
David A Adkins, MD
-
Dustin G Adkins, PA-C
-
Michael Dewayne Adkins, P.A.
-
Zachary B Adkins, MD
-
Aouod Agenor, MD
-
Chelsea Agnew, PA
-
Kristine K Agnew, P.A.C.
-
Saad Ajmal, M.D.
-
James Akins, M.D.
-
Talal Saleh Al Khawlani, MBBS
-
Gabriel E Al-Hajj, M.D.
-
Lauren Marie Alexander, PA-C
Medicare Care Compare: Hospital
- Listed as
- Charleston Area Medical Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
Hospital certification: CCN 510022
- Legal name
- CHARLESTON AREA MEDICAL CENTER INC
- Doing business as
- VANDALIA HEALTH CHARLESTON AREA MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jan 1, 1972
- Last certification
- Apr 11, 2014
- Beds
- 908
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 1, 1972 in WV
- Enrollment address
- 501 Morris St
Charleston, WV 25301-1326 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| John R Hoblitzell |
Corporate Director |
Apr 28, 2004 | |
| Melvin Jones |
Corporate Director |
Jan 1, 2016 | |
| Ken Tackett |
Corporate Director |
Jan 1, 2012 | |
| Edwin Welch |
Corporate Director |
Jan 1, 1993 | |
| Fonda Elliot |
Corporate Director |
Jan 1, 2012 | |
| Glenn Crotty |
Corporate Director |
Mar 28, 2004 | |
| W-2 Managing Employee | Mar 28, 2004 | ||
| David L Ramsey |
5% Or Greater Indirect Ownership Interest |
Sep 1, 2000 | 40% |
| Corporate Officer |
Sep 1, 2000 | ||
| Corporate Director |
Sep 1, 2000 | ||
| W-2 Managing Employee | Sep 1, 2000 | ||
| Operational/Managerial Control |
Sep 1, 2000 | ||
| Mark a Chandler |
Corporate Director |
Jan 24, 2007 | |
| Chad Hovis |
W-2 Managing Employee |
Sep 1, 2022 | |
| James Robert Campbell |
Corporate Director |
Jan 1, 2023 | |
| Vandalia Health Inc |
5% Or Greater Direct Ownership Interest | Sep 1, 2022 | 100% |
| Operational/Managerial Control | Sep 1, 2022 | 100% | |
| Jeffrey D Sandene |
Corporate Director |
Dec 1, 2023 | |
| W-2 Managing Employee |
Dec 1, 2023 | ||
| Charles Capito |
Corporate Director |
Jan 1, 2011 | |
| Karen Price |
Corporate Director |
Feb 25, 2009 | |
| Stefan R Maxwell |
Corporate Director |
Jan 1, 2021 | |
| Eric a Hicks |
Corporate Director |
Jan 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031223000426 | WV | Part B Supplier - Clinic/Group Practice | 3375441637 |
Receives reassigned benefits from 1,595 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20071210000438 | WV | Part a Provider - Hospital | 3375441637 |
10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Camc Physicians Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Yes |
Addresses
Primary practice location
211 W Maple Ave
Fayetteville, WV 25840-1445
Mailing address
211 W Maple Ave
Fayetteville, WV 25840-1413
Phone (304) 900-5511
Other names
- Vandalia Health Multi-Specialty Office
Other providers in Fayetteville, WV
- Cassis Dental Center, PLLC
- Bruce L Cassis
- Daniel Joseph Cassis
- Angela C Chambers
- Charleston Area Medical Center Inc
- Madison Chase McCreary
- Jennifer Lea Coffman
- Heather Renee Collins
- Community Health Systems Inc.
- Lewis A. Cook
All providers in Fayetteville, WV · General Acute Care Hospital in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.