NPIMap

Page Memorial Hospital Inc.

Organization Active NPI Rural Health Clinic/Center · Luray, VA

NPI 1376794859 · NPPES record last updated Sep 2, 2022

Key facts

NPI
1376794859
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
PAGE MEMORIAL HOSPITAL INC.
Practice address
125 Memorial Dr
Luray, VA 22835-1016
Phone
(540) 743-2282
Fax
(540) 743-6538
NPI assigned
Oct 2, 2008
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 11

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

Other NPIs with the same Medicare PAC ID 6

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

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

Facilities with the same owner 19

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

Practitioners 85

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 85

Laboratory certificates & supplier records

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

CLIA laboratory certificates

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in VA

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
Corporation · Non-profit
Incorporated
Dec 17, 1925 in VA
Enrollment address
125 Memorial Dr
Luray, VA 22835-1016
Related CCNs
491307

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

Medicare enrollment records

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Rural Health Clinic/Center 261QR1300X Yes

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

  • Valley Health Page Memorial Hospital Multispecialty Clinic Doing business as

Other providers in Luray, VA

All providers in Luray, VA · Rural Health Clinic/Center in Virginia

Sources for this page

Verify at the official NPI Registry.