NPIMap

Organization Active NPI

E. a. Hawse Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Romney, WV
National Provider Identifier
1467054981
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
E. A. HAWSE HEALTH CENTER, INC.
Practice address
22347 Northwestern Pike
Romney, WV 26757-6343
Phone
(304) 822-3838
NPI assigned
Nov 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Authorized official

Name
Meredith Michelle Heishman
Title
Credentialing
Phone
(304) 897-5915

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

22347 Northwestern Pike
Romney, WV 26757-6343

Mailing address

PO Box 97
Baker, WV 26801-0097
Phone (304) 897-5915

Other names 1

  • E. A. HAWSE HEALTH CENTER, INC.-ROMNEY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210115002355 WV Part A Provider - Federally Qualified Health Center (FQHC) 6204728041 Practice locations: Romney, WV

Federally qualified health center certification: CCN 511193

Legal name
E. A. HAWSE HEALTH CENTER, INC.
Doing business as
E. A. HAWSE HEALTH CENTER, INC.-ROMNEY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 22, 2020
Last certification
Aug 22, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 10, 1980 in WV
Enrollment address
22347 Northwestern Pike
Romney, WV 26757-6343

Other NPIs with the same Medicare PAC ID 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
E a Hawse Health Center Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

400 N Main St
Moorefield, WV 26836
Phone (304) 530-6356

207 Viking Dr
Petersburg, WV 26847
Phone (304) 257-1444

45 School St
Romney, WV 26757

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Celesta Miller Individual Corporate OfficerSecretary Feb 1, 2020
Brenda Leigh Thompson Individual Operational/Managerial ControlAdministrative Assistant Dec 4, 2001
Joann Kuhn Individual Corporate Director Nov 1, 2019
Ralph Fitzwater Individual Corporate OfficerBoard President Dec 1, 2019
Cheryl L Sherman Individual Operational/Managerial ControlBilling Supervisor Oct 1, 2018
Stacey Heavner Individual Corporate Director Dec 1, 2009
Kristopher Kerr Individual Corporate Director Dec 1, 2016
David Mayfield Individual Corporate OfficerTreasurer Jun 1, 2020
James Pyles Individual Corporate Director Jun 1, 2018
Melissa Thompson Individual W-2 Managing EmployeeCeo Jan 1, 2019
Tracey Ratliff Individual Corporate Director Oct 1, 2009
Regina Whetzel Individual Corporate OfficerVice President Nov 1, 2011

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1467054981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "BAKER",
            "state": "WV",
            "postal_code": "268010097",
            "telephone_number": "304-897-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22347 NORTHWESTERN PIKE",
            "city": "ROMNEY",
            "state": "WV",
            "postal_code": "267576343",
            "telephone_number": "304-822-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. A. HAWSE HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "HEISHMAN",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "304-897-5915"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "E. A. HAWSE HEALTH CENTER, INC.-ROMNEY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Romney, WV

Sources for this page

Verify at the official NPI Registry.