NPIMap

Organization Active NPI

Rainelle Medical Center, Inc

Doing business as Lewisburg Behavioral Health Center

  • Federally Qualified Health Center (FQHC)
  • Lewisburg, WV
National Provider Identifier
1265068001
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RAINELLE MEDICAL CENTER, INC
Doing business as
Lewisburg Behavioral Health Center
Practice address
149 Goheen St
Lewisburg, WV 24901-1661
Phone
(304) 438-6188
Fax
(304) 438-4037
NPI assigned
Mar 12, 2020
Last updated
Mar 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Mental Health Counselor 101YM0800X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

149 Goheen St
Lewisburg, WV 24901-1661

Mailing address

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

Other names 1

  • LEWISBURG BEHAVIORAL HEALTH CENTER Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200504000524 WV Part A Provider - Federally Qualified Health Center (FQHC) 7416861810 Practice locations: Lewisburg, WV
O20210315000726 WV Part B Supplier - Clinic/Group Practice 7416861810 Receives reassigned benefits from 15 practitioners
Practice locations: Lewisburg, WV

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1265068001. Details of each certification follow.

Federally qualified health center certification: CCN 511181

Legal name
RAINELLE MEDICAL CENTER INC
Doing business as
LEWISBURG BEHAVIORAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 10, 2020
Last certification
Apr 10, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 13, 1988 in WV
Enrollment address
149 Goheen St
Lewisburg, WV 24901-1661

Federally qualified health center certification: CCN 511186

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LEWISBURG BEHAVIORAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 4, 2020
Last certification
May 4, 2020
Ownership / control type
For profit – corporation
Facility address
149 Goheen Street
Lewisburg, WV 24901

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

National Provider Directory

National Provider Directory
Tax ID family
Rainelle Med Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

1457 Jefferson St N
Lewisburg, WV 24901

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
Debra J Bennett Individual Corporate DirectorDirector of Credentialing Jan 2, 1999
Christopher Clay Individual W-2 Managing EmployeeCfo Dec 15, 2008
Frank Mullins Individual Corporate DirectorBod Jan 1, 2015
George Hall Individual Corporate DirectorBod Jan 1, 2006

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 4

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
RMC Greenbrier Nephrology AlleghanyCovington, VA, CCN 491974 Federally qualified health center Operational/Managerial Control Jul 1, 2020
Rupert Health CenterRupert, WV, CCN 581046 Federally qualified health center Operational/Managerial Control (100%) Jun 26, 2024

Owned or controlled facilities with NPI records 5

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

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": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1265068001",
    "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": "149 GOHEEN ST",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011661",
            "telephone_number": "304-438-6188",
            "fax_number": "304-438-4037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINELLE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEWISBURG BEHAVIORAL HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewisburg, WV

Sources for this page

Verify at the official NPI Registry.