NPIMap

Organization Active NPI

Herbert J Thomas Memorial Hospital Association

  • Psychiatric Hospital Unit
  • South Charleston, WV
National Provider Identifier
1275620809
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
39 Issued in WV
Legal business name
HERBERT J THOMAS MEMORIAL HOSPITAL ASSOCIATION
Practice address
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone
(304) 766-3536
Fax
(304) 766-4315
NPI assigned
Oct 6, 2006
Last updated
Jan 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Authorized official

Name
Deonna Danielle Diamond
Title
Director of Patient Accounts
Phone
(304) 766-3536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 39 WV Primary

Addresses

Primary practice location

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Mailing address

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 766-3536

Other identifiers 2

IdentifierTypeStateIssuer
0001391001MedicaidWV
0001391002MedicaidWV

Other names 1

  • HJ THOMAS MEMORIAL HOSPITAL Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071119000654 WV Part A Provider - Hospital 9931162104 Practice locations: Charleston, WV; South Charleston, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275620809. Details of each certification follow.

Hospital certification: CCN 51S029

Legal name
HERBERT J THOMAS MEMORIAL HOSPITAL ASSOCIATION
Doing business as
THOMAS MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jul 3, 1946 in WV
Enrollment address
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Herbert J Thomas Memorial H19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Albert Wright Individual Operational/Managerial Control Jan 1, 2023
Thomas Health System Organization, South Charleston, WV 5% Or Greater Direct Ownership Interest Nov 5, 2007
West Virginia United Health System, Inc Organization, Morgantown, WV Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2023 100%
Timothy Skeldon Individual Corporate OfficerSenior VP/Cfo Jul 24, 2017
W-2 Managing EmployeeSenior VP/Cfo Jul 24, 2017

Facilities with the same owner 52

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1275620809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-766-3536",
            "fax_number": "304-766-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-766-3536",
            "fax_number": "304-766-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERBERT J THOMAS MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "DEONNA",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "304-766-3536"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "WV",
            "license": "39",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001391001",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001391002",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "HJ THOMAS MEMORIAL HOSPITAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.