NPIMap

Organization Active NPI

Page Memorial Hospital, Inc.

  • Critical Access Hospital
  • Luray, VA
National Provider Identifier
1326040684
Registry record updated Aug 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H1880 Issued in VA
Legal business name
PAGE MEMORIAL HOSPITAL, INC.
Practice address
200 Memorial Dr
Luray, VA 22835
Phone
(540) 743-4561
Fax
(540) 743-9560
NPI assigned
Jun 1, 2005
Last updated
Aug 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2018

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

Authorized official

Name
Renee Nevada Johnson
Title
Credentialing Coordinator
Phone
(540) 536-0103

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H1880 VA
Critical Access Hospital 282NC0060X H1880 VA Primary

Addresses

Primary practice location

200 Memorial Dr
Luray, VA 22835

Mailing address

220 Campus Blvd Ste 200
Winchester, VA 22601-2889
Phone (540) 536-5100

Other identifiers 2

IdentifierTypeStateIssuer
004900472MedicaidVA
000027OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040129000420 VA Part B Supplier - Clinic/Group Practice 8426951203 Receives reassigned benefits from 386 practitioners
11 other NPIs on this enrollment
Practice locations: Stanley, VA; Shenandoah, VA; Luray, VA; Front Royal, VA
O20061104000563 VA Part A Provider - Critical Access Hospital 8426951203 Receives reassigned benefits from 56 practitioners
Practice locations: Luray, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326040684. Details of each certification follow.

Hospital certification: CCN 491307

Legal name
PAGE MEMORIAL HOSPITAL INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2005
Last certification
Dec 8, 2010
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 17, 1925 in VA
Enrollment address
200 Memorial Dr
Luray, VA 22835-1000
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 11

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Page Memorial Hospital, IncCCN 491307 · All quality measures
Overall star rating
5 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

160 Exeter Dr
Ste 104
Winchester, VA 22603
Phone (540) 431-3600

363 Sunrise Blvd
Romney, WV 26757
Phone (304) 822-4561

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Nelson T Clark Individual Corporate Director Dec 31, 2008
W-2 Managing Employee Oct 1, 2005
Valley Health System Organization, Winchester, VA Corporation 5% Or Greater Direct Ownership Interest Dec 31, 2008 100%
Jill Chambers Individual W-2 Managing Employee Sep 1, 2017

Facilities with the same owner 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 417

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 417

Affiliated clinicians 279

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 279

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534550400000",
    "number": "1326040684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 200",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012889",
            "telephone_number": "540-536-5100",
            "fax_number": "540-536-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEMORIAL DR",
            "city": "LURAY",
            "state": "VA",
            "postal_code": "22835",
            "telephone_number": "540-743-4561",
            "fax_number": "540-743-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGE MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2018-08-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "NEVADA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "540-536-0103"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VA",
            "license": "H1880",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "VA",
            "license": "H1880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004900472",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000027",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Luray, VA

Sources for this page

Verify at the official NPI Registry.