NPIMap

Organization Active NPI

Braxton County Memorial Hospital

  • Critical Access Hospital
  • Gassaway, WV
National Provider Identifier
1285025825
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
3 Issued in WV
Legal business name
BRAXTON COUNTY MEMORIAL HOSPITAL
Practice address
100 Hoylman Dr
Gassaway, WV 26624-9318
Phone
(304) 364-5156
Fax
(304) 364-5809
NPI assigned
Feb 17, 2015
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Kimberly Dawn Knight
Title
Cfo
Phone
(304) 364-1128

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 3 WV Primary

Addresses

Primary practice location

100 Hoylman Dr
Gassaway, WV 26624-9318

Mailing address

100 Hoylman Dr
Gassaway, WV 26624-9318
Phone (304) 364-5156

Other identifiers 1

IdentifierTypeStateIssuer
0100178001MedicaidWV

Other names 1

  • Braxton County Memorial Hospital Out Patient Other name

Electronic endpoints 2

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

National Provider Directory

National Provider Directory
Tax ID family
Braxton County Memorial Hospital4 organizations share this tax ID, including this one
Part of
Braxton County Memorial Hospital

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1285025825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOYLMAN DR",
            "city": "GASSAWAY",
            "state": "WV",
            "postal_code": "266249318",
            "telephone_number": "304-364-5156",
            "fax_number": "304-364-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOYLMAN DR",
            "city": "GASSAWAY",
            "state": "WV",
            "postal_code": "266249318",
            "telephone_number": "304-364-5156",
            "fax_number": "304-364-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAXTON COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL",
        "enumeration_date": "2015-02-17",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "304-364-1128"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WV",
            "license": "3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100178001",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Parkway",
            "address_2": "Suite 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "Braxton County Memorial Hospital Out Patient",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Braxton County Memorial Hospital Out Patient",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gassaway, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.