NPIMap

Organization Active NPI

Page Memorial Hospital Inc.

Doing business as Valley Health Page Memorial Hospital Multispecialty Clinic

  • Rural Health Clinic/Center
  • Luray, VA
National Provider Identifier
1376794859
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PAGE MEMORIAL HOSPITAL INC.
Doing business as
Valley Health Page Memorial Hospital Multispecialty Clinic
Practice address
125 Memorial Dr
Luray, VA 22835-1016
Phone
(540) 743-2282
Fax
(540) 743-6538
NPI assigned
Oct 2, 2008
Last updated
Sep 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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
Community/Behavioral Health Agency 251S00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

125 Memorial Dr
Luray, VA 22835-1016

Mailing address

220 Campus Blvd Ste 100
Winchester, VA 22601-2896
Phone (540) 536-5100

Other names 1

  • Valley Health Page Memorial Hospital Multispecialty Clinic Doing business as

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
This NPI is an additional NPI on the enrollment
Practice locations: Stanley, VA; Shenandoah, VA; Luray, VA; Front Royal, VA
O20190603003170 VA Part A Provider - Rural Health Clinic 8426951203 Practice locations: Luray, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376794859. Details of each certification follow.

Rural health clinic certification: CCN 493438

Legal name
PAGE MEMORIAL HOSPITAL INC
Doing business as
VALLEY HEALTH PAGE MEMORIAL HOSPITAL MULTISPECIALTY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 2019
Last certification
Jul 1, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 17, 1925 in VA
Enrollment address
125 Memorial Dr
Luray, VA 22835-1016
Related CCNs
491307

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.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2162641Valley Health Page Memorial Hospital125 Memorial Drive, Luray, VA 22835Certificate of waiverFeb 26, 2027

National Provider Directory

National Provider Directory

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 Officer Jul 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 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1376794859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012896",
            "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": "125 MEMORIAL DR",
            "city": "LURAY",
            "state": "VA",
            "postal_code": "228351016",
            "telephone_number": "540-743-2282",
            "fax_number": "540-743-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGE MEMORIAL HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "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": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Page Memorial Hospital Multispecialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health Page Memorial Hospital Multispecialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Luray, VA

Sources for this page

Verify at the official NPI Registry.