Shenandoah Memorial Hospital, Inc.
Organization Active NPI Surgery Physician · Woodstock, VA
NPI 1407357015 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1407357015
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- SHENANDOAH MEMORIAL HOSPITAL, INC.
- Practice address
- 759 S Main St
Woodstock, VA 22664-1154 - Phone
- (540) 459-1100
- NPI assigned
- Feb 28, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- SHENANDOAH MEMORIAL HOSPITAL, INC.
Authorized official
- Name
- Renee Nevada Johnson
- Title
- Credentialing Coordinator
- Phone
- (540) 536-0103
Owned or controlled facilities with NPI records 4
Other NPIs with the same Medicare PAC ID 5
Practitioners 370
-
Leen Al-Faris, MD
-
Gregory S Byrd, M.D.
-
Angela M Emmons, PA-C
-
Muhammad Jamal, MD
-
Julian E. Martinez, M.D.
-
Yaqeen Qudah, M.D
-
Rabia Qaiser, M.D.
-
Emerencienne D Yonga, M.D.
-
Daniel M Freed, OD, MD
-
Matthew Tyler Lisk Sr., D.O.
-
Wissam Sabri Zaeeter, M.D.
-
Josette J Zeilah, M.D.
-
Faizan Ahmad, PA-C
-
Jerry A Germroth, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Valley Health Shenandoah Memorial Hospital Pediatrics |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 2017 |
| Shenandoah Memorial Hospital, Inc. |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 2017 |
| Valley Health Shenandoah Memorial Hospital Multispecialty Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 2017 |
| Valley Health Primary Care Strasburg |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180430001662 | VA | Part B Supplier - Clinic/Group Practice | 2466360375 |
Receives reassigned benefits from 61 practitioners Practice locations: Woodstock, VA |
National Provider Directory
- Part of
- Shenandoah Cty Mem Hospcna
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician |
207T00000X | VA | ||
| Obstetrics & Gynecology Physician |
207V00000X | VA | ||
| Orthopaedic Surgery Physician |
207X00000X | VA | ||
| Otolaryngology Physician |
207Y00000X | VA | ||
| Surgery Physician |
208600000X | VA | Yes | |
| Urology Physician |
208800000X | VA | ||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
208G00000X | VA |
Addresses
Primary practice location
759 S Main St
Woodstock, VA 22664-1154
Mailing address
220 Campus Blvd Ste 200
Winchester, VA 22601-2889
Other practice location 1
200 Memorial Dr
Luray, VA 22835-1000
Phone (540) 743-4561
Other practice location 2
1000 N Shenandoah Ave
Front Royal, VA 22630-3547
Phone (540) 636-0300
Other practice location 3
1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000
Other providers in Woodstock, VA
- Shenandoah Memorial Hospital
- Shenandoah Memorial Hospital
- Shenandoah Memorial Hospital Inc.
- Shenandoah Memorial Hospital Inc.
- Shenandoah Memorial Hospital, Inc.
- Shenandoah Memorial Hospital, Inc.
- Shenandoah Optical Inc
- Shenandoah Pediatrics, PC
- Shenandoah Valley Health Services LLC
- Mesfin Rese Shibeshi
All providers in Woodstock, VA · Surgery Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.