Community Health Systems Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COMMUNITY HEALTH SYSTEMS INC.

Doing business as

AccessHealth Shady Spring High School-Based Clinic

Practice address

300 Hinton Rd
Shady Spring, WV 25918-8406

Phone

(304) 252-8551

NPI assigned

Sep 4, 2015

Last updated

Dec 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles Hunt

Title

Ceo

Phone

(304) 252-8324

Specialties & licenses 1

Addresses

Other names 1

• AccessHealth Shady Spring High School-Based Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336517580. Details of each certification follow.

• CCN 511090 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 511090

Legal name

COMMUNITY HEALTH SYSTEMS INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 2, 2016

Last certification

Feb 2, 2016

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jun 20, 1967 in WV

Enrollment address

300 Hinton Rd
Shady Spring, WV 25918-8406

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 1

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

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1336517580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HINTON RD",
            "city": "SHADY SPRING",
            "state": "WV",
            "postal_code": "259188406",
            "telephone_number": "304-252-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HINTON RD",
            "city": "SHADY SPRING",
            "state": "WV",
            "postal_code": "259188406",
            "telephone_number": "304-252-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH SYSTEMS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-252-8324",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AccessHealth Shady Spring High School-Based Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tonia Sue Castle
• Clay and Hiener Dentistry Partnership (Shady Spring Dental Care)
• Ethel Cole
• Community Health Systems Inc (AccessHealth)
• Community Health Systems Inc (AccessHealth School Based Shady Spring Elementary School)
• Carma Concepcion
• Charlotte Cox
• Holli Davis
• Stacey F. Davis
• Lori Day

• Family Medicine Physician in Shady Spring, WV
• Providers in Shady Spring, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.