NPIMap

Organization Active NPI

Grant Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Moorefield, WV
National Provider Identifier
1245238237
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
GRANT MEMORIAL HOSPITAL
Practice address
8 Lee St
Suite 3
Moorefield, WV 26836-1091
Phone
(304) 538-7707
Fax
(304) 538-7706
NPI assigned
Jul 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sandy M Michaels
Title
Chief Financial Officer
Phone
(305) 257-1026

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

8 Lee St
Suite 3
Moorefield, WV 26836-1091

Mailing address

PO Box 1019
Petersburg, WV 26847-1019
Phone (304) 257-1026

Other identifiers 1

IdentifierTypeStateIssuer
0001375015MedicaidWV

Other names 1

  • Potomac Valley Family Medicine-Petersburg Doing business as

National Provider Directory

National Provider Directory

Locations

8 Lee St
Ste 3
Moorefield, WV 26836
Phone (304) 538-7707

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245238237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1019",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471019",
            "telephone_number": "304-257-1026",
            "fax_number": "304-257-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 LEE ST",
            "address_2": "SUITE 3",
            "city": "MOOREFIELD",
            "state": "WV",
            "postal_code": "268361091",
            "telephone_number": "304-538-7707",
            "fax_number": "304-538-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MICHAELS",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "305-257-1026"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001375015",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac Valley Family Medicine-Petersburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moorefield, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.