NPIMap

Organization Active NPI

Monongahela Valley Association of Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Monongah, WV
National Provider Identifier
1285093039
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTER, INC.
Doing business as
Monongah Elementary School Wellness Center
Practice address
628 Walnut St
Monongah, WV 26554-1136
Phone
(304) 367-2159
Fax
(304) 366-9529
NPI assigned
Feb 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Authorized official

Name
Nancy L Vandergrift
Title
President
Phone
(304) 367-8740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

628 Walnut St
Monongah, WV 26554-1136

Mailing address

628 Walnut St
Monongah, WV 26554-1136
Phone (304) 367-2159

Other names 1

  • Monongah Elementary School Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080220000201 WV Part B Supplier - Public Health/Welfare Agency 6800991977 Receives reassigned benefits from 20 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shinnston, WV; Mannington, WV; Fairmont, WV; Farmington, WV

Federally qualified health center certification: CCN 511106

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
MONONGAH ELEMENTARY SCHOOL WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 14, 2016
Last certification
Apr 14, 2016
Ownership / control type
For profit – corporation
Facility address
628 Walnut Street
Monongah, WV 26554

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Locations

628 Walnut St
Monongah, WV 26554
Phone (304) 367-2159

Practitioners & affiliated clinicians

Practitioners 1

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": "1456099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1285093039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 WALNUT ST",
            "city": "MONONGAH",
            "state": "WV",
            "postal_code": "265541136",
            "telephone_number": "304-367-2159",
            "fax_number": "304-366-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 WALNUT ST",
            "city": "MONONGAH",
            "state": "WV",
            "postal_code": "265541136",
            "telephone_number": "304-367-2159",
            "fax_number": "304-366-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-22",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "VANDERGRIFT",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-367-8740"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monongah Elementary School Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Monongah Elementary School Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monongah, WV

Sources for this page

Verify at the official NPI Registry.