NPIMap

Organization Active NPI

Grant Memorial Hospital

Doing business as Potomac Valley Physicians for Women

  • Multi-Specialty Clinic/Center
  • Petersburg, WV
National Provider Identifier
1396744108
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
GRANT MEMORIAL HOSPITAL
Doing business as
Potomac Valley Physicians for Women
Practice address
Hospital Drive
Petersburg, WV 26847
Phone
(304) 257-2152
Fax
(304) 257-2928
NPI assigned
Jul 14, 2005
Last updated
Jan 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Authorized official

Name
Ms. Mary Beth Barr
Title
Ceo
Phone
(304) 257-1026

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

Hospital Drive
Petersburg, WV 26847

Mailing address

PO Box 1019
Petersburg, WV 26847-1019
Phone (304) 257-1026

Other identifiers 1

IdentifierTypeStateIssuer
0206602000MedicaidWV

Other names 1

  • Potomac Valley Physicians for Women Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

90 E Southern Dr
Keyser, WV 26726
Phone (304) 597-2028

65 Hospital Dr
#104
Petersburg, WV 26847
Phone (304) 257-2152

Practitioners & affiliated clinicians

Practitioners 2

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": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1396744108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1019",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471019",
            "telephone_number": "304-257-1026",
            "fax_number": "304-257-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL DRIVE",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "26847",
            "telephone_number": "304-257-2152",
            "fax_number": "304-257-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "BARR",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-257-1026",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206602000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac Valley Physicians for Women",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.