Stonewall Jackson Memorial Hospital Company
Organization Active NPI Rural Acute Care Hospital · Weston, WV
NPI 1477559433 · NPPES record last updated Jul 6, 2022
Key facts
- NPI
- 1477559433
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Acute Care Hospital 282NR1301X
- License
- 510038 (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
- Organization subpart
- No
Authorized official
- Name
- Mr. C Richard Scherich
- Title
- VP of Finance
- Phone
- (304) 269-8050
Owners & managing parties with NPI records 2
-
Tyler J Hall, DO
-
Doyle Russell Sickles, M.D.
Facilities with the same owner 18
Practitioners 169
-
David Allen Anderson, DPM
-
John A Battin, M.D.
-
Benjamin Michael Blick, CRNA
-
Elizabeth Kae Boram, PA-C
-
Robert Adam Burnside, CRNA
-
Katie Carter, CRNA
-
Marquita Renae Casto, MSN, APRN, FNP-C
-
Samantha Jane Crites, D.O.
-
Colin Dennis Fee, M.D.
-
Shawn Michael Gee, M.D.
-
Wissam Gharib, M. D.
-
Robert L Goodson, CRNA
-
Lindsey Marie Hall, PA-C
-
Tyler J Hall, DO
-
Teresa Denise Harkins, FNP-C
-
Filip Ionescu, MD
-
Leigh Anne Jackson, FNP-BC
Affiliated clinicians 105
-
Ahmed Aboraya, M.D.
-
Adnan Alghadban, M.D.
-
David Allen Anderson, DPM
-
Allison Grace Bardes, M.D.
-
John A Battin, M.D.
-
Russell Biundo, MD
-
Benjamin Michael Blick, CRNA
-
Elizabeth Kae Boram, PA-C
-
Jordan Bowers, PA-C
-
Katie Carter, CRNA
-
Marquita Renae Casto, MSN, APRN, FNP-C
-
Pradeep Chadha, M.D.
-
Diana Lynn Cooper, FNP-C
-
Zachary Curtis, M.D.
-
Amanda E Dawson, PA-C
-
James J Demarco, MD
-
Noah Atire Ene, MD
-
Colin Dennis Fee, M.D.
Medicare Care Compare: Hospital
- Listed as
- Stonewall Jackson Memorial Hospital Company
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
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
- Corporation · Non-profit
- Incorporated
- Feb 15, 1958 in WV
- Enrollment address
- 230 Hospital PLZ
Weston, WV 26452-8558 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Tyler J Hall |
W-2 Managing Employee |
Jan 1, 2024 | |
| David Goldberg |
Corporate Director |
Oct 1, 2018 | |
| John Law |
Corporate Director | Mar 10, 2004 | |
| Clyde Richard Scherich |
W-2 Managing Employee |
Mar 27, 2020 | |
| Alissa Lambert |
Corporate Director |
Jan 1, 2022 | |
| Gregory St. Clair |
Corporate Director |
Aug 9, 2017 | |
| Ralph Gerald Wood |
Corporate Director | Jan 10, 1997 | |
| George Stansbury |
Corporate Director |
Jan 1, 2022 | |
| Kimberly Gum |
Corporate Director |
Aug 9, 2017 | |
| Vandalia Health Inc |
5% Or Greater Direct Ownership Interest | Sep 1, 2022 | 100% |
| Operational/Managerial Control | Sep 1, 2022 | 100% | |
| Joseph a Snead |
Corporate Director | Dec 9, 1987 | |
| Kevin Stalnaker |
Corporate Officer |
Nov 20, 2020 | |
| W-2 Managing Employee |
Oct 1, 2017 | ||
| Doyle R Sickles |
Corporate Director |
Aug 1, 2021 | |
| C. Gregory Cunningham |
Corporate Director |
Jan 20, 2016 | |
| Robin Poling |
Corporate Director | Jan 19, 2011 | |
| Monongalia Health System, Inc. |
Operational/Managerial Control | Oct 1, 2017 | |
| Other | Oct 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
215 Gilbert St
Blacksburg, VA 24060
Phone (540) 961-8040
2900 Lamb Cir
Ste 210
Christiansburg, VA 24073
Phone (540) 639-9651
2900 Lamb Cir
Ste 250
Christiansburg, VA 24073
Phone (540) 639-9071
2900 Lamb Cir
Ste 310
Christiansburg, VA 24073
108 Houston St
Ste E
Lexington, VA 24450
Phone (540) 463-2227
108 Houston St
Ste Ace
Lexington, VA 24450
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Acute Care Hospital | 282NR1301X | 510038 | WV | Yes |
Addresses
Primary practice location
230 Hospital PLZ
Weston, WV 26452-8558
Mailing address
230 Hospital PLZ
Weston, WV 26452-8558
Phone (304) 269-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001417000 | Medicaid | WV |
Other providers in Weston, WV
- Stonewall Jackson Memorial Hospital
- Stonewall Jackson Memorial Hospital
- Stonewall Jackson Memorial Hospital
- Stonewall Jackson Memorial Hospital
- Stonewall Jackson Memorial Hospital Co
- Stonewall Jackson Memorial Hospital Company
- Stonewall Jackson Memorial Hospital Med Group
- Christina Strader
- Beverly Straley
- Amanda Bonnell Strauss
All providers in Weston, WV · Rural Acute Care Hospital in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2022. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.