NPIMap

Organization Active NPI

Valley Health Systems Inc

Doing business as Valley Health Hurricane

  • Federally Qualified Health Center (FQHC)
  • Hurricane, WV
National Provider Identifier
1225154206
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VALLEY HEALTH SYSTEMS INC
Doing business as
Valley Health Hurricane
Practice address
3729 Teays Valley Rd
Suite 100
Hurricane, WV 25526
Phone
(304) 760-6040
Fax
(304) 760-6042
NPI assigned
Mar 22, 2007
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X WV Primary
Family Medicine Physician 207Q00000X 820 WV

Addresses

Primary practice location

3729 Teays Valley Rd
Suite 100
Hurricane, WV 25526

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
3810009791MedicaidWV
0069819MedicaidOH
0069859MedicaidOH
CJ2698OtherWVRR MEDICARE GROUP

Other names 1

  • Valley Health Hurricane Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325000411 WV Part B Supplier - Public Health/Welfare Agency 9931017969 Receives reassigned benefits from 154 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntington, WV; Wayne, WV; Ona, WV; Kermit, WV; Hurricane, WV; Harts, WV; Fort Gay, WV; Cedar Grove, WV
O20070403000021 WV Part A Provider - Federally Qualified Health Center (FQHC) 9931017969 Practice locations: Hurricane, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225154206. Details of each certification follow.

Federally qualified health center certification: CCN 511929

Legal name
VALLEY HEALTH SYSTEMS, INC
Doing business as
VALLEY HEALTH HURRICANE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 11, 2007
Last certification
Jul 11, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 2011 in WV
Enrollment address
3729 Teays Valley Rd
Ste 100
Hurricane, WV 25526-9705

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Sherry Perry Individual Corporate Director Mar 31, 2007
Christina Walter Individual Corporate DirectorBoard Member Apr 25, 2019
Jared Colker Individual Corporate DirectorBoard Member Dec 8, 2016
Debra Zuberbuehler Individual Corporate DirectorBoard Member Jan 1, 2025
Paulette Mabry Individual Corporate DirectorBoard Member Dec 8, 2016
Bill Bryant Individual Corporate DirectorBoard Member Jan 1, 2011
Suzi Brodof Individual Corporate DirectorBoard Member Oct 26, 2017
Mathew Weimer Individual Corporate Officer Sep 28, 2024
W-2 Managing Employee Sep 28, 2024
Sherrone Hornbuckle Individual Corporate DirectorBoard Member Oct 26, 2017
Mary-Beth Brubeck Individual Corporate OfficerExecutive Vice President / Cfo Jan 1, 2019
Kalyn Obiozor Dorey Individual Corporate Director Nov 22, 2022
Greg Agee Individual Corporate Director Mar 31, 2007
Xavier Staggs Individual Corporate DirectorBoard Member Jan 1, 2025
Benjamin L Howard Individual Corporate Director Mar 31, 2007

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Valley Health Apple GroveApple Grove, WV, CCN 581056 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 16, 1975
Valley Health SCP - Charleston 108Charleston, WV, CCN 581062 Federally qualified health center Operational/Managerial Control Feb 1, 2024

Practitioners & affiliated clinicians

Practitioners 140

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 140

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1225154206",
    "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": "3729 TEAYS VALLEY RD",
            "address_2": "SUITE 100",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "25526",
            "telephone_number": "304-760-6040",
            "fax_number": "304-760-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WV",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "820",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009791",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069819",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069859",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CJ2698",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Hurricane",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health Hurricane",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hurricane, WV

Sources for this page

Verify at the official NPI Registry.