NPIMap

E.a. Hawse Health Center Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Mathias, WV

NPI 1225096027 · NPPES record last updated Jan 29, 2020

Key facts

NPI
1225096027
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
E.A. HAWSE HEALTH CENTER INC.
Practice address
106 Harold K Michaels Dr
Mathias, WV 26812-8142
Phone
(304) 897-5915
Fax
(304) 897-6216
NPI assigned
May 2, 2006
Organization subpart
No

Authorized official

Name
Ms. Melissa Walls
Title
Ceo
Phone
(304) 897-5915

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 17

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

Corporate family (same tax ID) 23

Organizations that report the same tax identification number in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 36

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

View all 36

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2121808E a Hawse Health Center Mathias
106 Harold Michael Drive, Mathias, WV 26812		Certificate of waiverNov 16, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WV

Federally qualified health center certification: CCN 511869

Legal name
E. A. HAWSE HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 19, 1998
Last certification
Nov 19, 1998
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Mar 7, 1979 in WV
Enrollment address
106 Harold K Michaels Dr
Mathias, WV 26812-8142
Related CCNs
511845

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Brenda Leigh Thompson
Individual 		Operational/Managerial Control Apr 1, 2003
Joann Kuhn
Individual 		Corporate Director Nov 1, 2019
Ralph Fitzwater
Individual 		Corporate Director May 1, 2010
Cheryl L Sherman
Individual 		Operational/Managerial Control Aug 22, 1989
Jeffrey M Feit
Individual 		Corporate Director Aug 1, 2018
Stacey Heavner
Individual 		Corporate Director May 1, 2009
Kristopher Kerr
Individual 		Corporate Director Jul 1, 2016
Carol B Lindsey
Individual 		Corporate Director Apr 1, 2012
Tim Ramsey
Individual 		Corporate Director May 1, 2008
James Pyles
Individual 		Corporate Officer Feb 1, 2010
Melissa Thompson
Individual 		Corporate Director
Ceo		 Jan 1, 2019
W-2 Managing Employee Jan 1, 2019 100%
Tracey Ratliff
Individual 		Corporate Director May 1, 2010
Regina Whetzel
Individual 		Corporate Director Nov 1, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20101221001043 WV Part a Provider - Federally Qualified Health Center (FQHC) 6204728041 Practice locations: Mathias, WV

National Provider Directory

Tax ID family
E a Hawse Health Center Inc (24 organizations share this tax ID)

Locations

106 Harold K Michaels Dr
#132
Mathias, WV 26812

8 Lee St
Moorefield, WV 26836
Phone (304) 538-7707

333 Rig St
Petersburg, WV 26847
Phone (304) 257-1110

111 S Grove St
Petersburg, WV 26847
Phone (304) 257-2451

296 Calvert Dr
Romney, WV 26757

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208D00000X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

106 Harold K Michaels Dr
Mathias, WV 26812-8142

Mailing address

PO Box 97
Baker, WV 26801-0097
Phone (304) 897-5915

Other identifiers

IdentifierTypeStateIssuer
2099006000MedicaidWV

Other names

  • Hawse Health Center Doing business as

Other providers in Mathias, WV

All providers in Mathias, WV · Federally Qualified Health Center (FQHC) in West Virginia

Sources for this page

Verify at the official NPI Registry.