NPIMap

Organization Active NPI

Stonewall Jackson Memorial Hospital Company

  • Rural Acute Care Hospital
  • Weston, WV
National Provider Identifier
1477559433
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
510038 Issued in WV
Legal business name
STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY
Practice address
230 Hospital PLZ
Weston, WV 26452-8558
Phone
(304) 269-8000
Fax
(304) 269-8090
NPI assigned
Jun 24, 2005
Last updated
Jul 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Authorized official

Name
Mr. C Richard Scherich
Title
VP of Finance
Phone
(304) 269-8050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 510038 WV Primary

Addresses

Primary practice location

230 Hospital PLZ
Weston, WV 26452-8558

Mailing address

230 Hospital PLZ
Weston, WV 26452-8558
Phone (304) 269-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031209000046 WV Part A Provider - Hospital 4284530551 Practice locations: Weston, WV; Buckhannon, WV
O20040130000739 WV Part B Supplier - Clinic/Group Practice 4284530551 Receives reassigned benefits from 157 practitioners
Practice locations: Weston, WV; Buckhannon, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477559433. Details of each certification follow.

Hospital certification: CCN 510038

Legal name
STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 23, 2014
Beds
70
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 15, 1958 in WV
Enrollment address
230 Hospital PLZ
Weston, WV 26452-8558
Main/Primary Hospital Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Stonewall Jackson Memorial Hospital CompanyCCN 510038 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

108 Houston St
Ste Ace
Lexington, VA 24450

132 Cinema Cir
Buckhannon, WV 26201
Phone (304) 473-0670

249 W 2nd St
Weston, WV 26452
Phone (304) 269-8097

251 W 2nd St
#1
Weston, WV 26452
Phone (304) 269-3929

66 Hospital Plz
Ste 102
Weston, WV 26452
Phone (304) 269-4252

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Tyler J Hall Individual W-2 Managing EmployeeMD; Jan 1, 2024
David Goldberg Individual Corporate DirectorMon Health President & Ceo Oct 1, 2018
John Law Individual Corporate Director Mar 10, 2004
Clyde Richard Scherich Individual W-2 Managing EmployeeVP Financial Services Mar 27, 2020
Alissa Lambert Individual Corporate DirectorBoard Member Jan 1, 2022
Gregory St. Clair Individual Corporate DirectorBoard Member Aug 9, 2017
Ralph Gerald Wood Individual Corporate Director Jan 10, 1997
George Stansbury Individual Corporate DirectorBoard Member Jan 1, 2022
Kimberly Gum Individual Corporate DirectorSecretary/Treasurer Aug 9, 2017
Vandalia Health Inc Organization, Charleston, WV Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2022 100%
Operational/Managerial Control Sep 1, 2022 100%
Joseph a Snead Individual Corporate Director Dec 9, 1987
Kevin Stalnaker Individual Corporate OfficerCao Nov 20, 2020
W-2 Managing EmployeeAssistant Ceo Oct 1, 2017
Doyle R Sickles Individual Corporate DirectorBoard Member Aug 1, 2021
C. Gregory Cunningham Individual Corporate DirectorVice Chair Jan 20, 2016
Robin Poling Individual Corporate Director Jan 19, 2011
Monongalia Health System, Inc. Organization, Morgantown, WV Corporation, Non-profit, Chain home office Operational/Managerial Control Oct 1, 2017
Other Oct 1, 2017

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 169

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.

View all 169

Affiliated clinicians 105

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 105

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1477559433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HOSPITAL PLZ",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264528558",
            "telephone_number": "304-269-8000",
            "fax_number": "304-269-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HOSPITAL PLZ",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264528558",
            "telephone_number": "304-269-8000",
            "fax_number": "304-269-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "SCHERICH",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "304-269-8050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "WV",
            "license": "510038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WV

Sources for this page

Verify at the official NPI Registry.