NPIMap

Organization Active NPI

Camc Greenbrier Valley Medical Center Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Ronceverte, WV
National Provider Identifier
1487370540
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
CAMC GREENBRIER VALLEY MEDICAL CENTER INC
Practice address
1320 Maplewood Avenue
Ronceverte, WV 24970-8016
Phone
(304) 647-6006
Fax
(304) 388-6782
NPI assigned
Oct 19, 2022
Last updated
Oct 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CAMC GREENBRIER VALLEY MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Authorized official

Name
Mr. Chad Hovis
Title
VP Finance
Phone
(304) 388-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

1320 Maplewood Avenue
Ronceverte, WV 24970-8016

Mailing address

501 Morris Street
Charleston, WV 25301-1326
Phone (304) 388-6251

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230117001488 WV Part A Provider - Hospital 1254702962 Practice locations: Ronceverte, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487370540. Details of each certification follow.

Hospital certification: CCN 51U002

Legal name
CAMC GREENBRIER VALLEY MEDICAL CENTER INC
Organization structure
CorporationProprietary
Incorporated
Sep 14, 2022 in WV
Enrollment address
1320 Maplewood Ave
Ronceverte, WV 24970-8016
Hospital Swing-Bed Unit
Hospital subgroups
Acute care, Swing-bed approved

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Camc Greenbrier Valley Medical Center Inc5 organizations share this tax ID, including this one
Part of
Camc Greenbrier Valley Medical Center Inc

Other organizations with this tax ID 4

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27854/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Glenn Crotty Individual Corporate DirectorVice President Jan 1, 2023
David L Ramsey Individual Corporate DirectorPresident Jan 1, 2023
Chad Hovis Individual Corporate DirectorVP of Finance Jan 1, 2023
W-2 Managing EmployeeVP of Finance Jan 1, 2023
Vandalia Health Inc Organization, Charleston, WV Corporation 5% Or Greater Direct Ownership Interest Sep 1, 2022 100%
Operational/Managerial Control Sep 1, 2022 100%
Jeffrey D Sandene Individual Corporate DirectorTreasurer Jan 1, 2023
W-2 Managing EmployeeTreasurer Jan 1, 2023

Owners & managing parties with NPI records 1

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

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 8

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.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1487370540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MORRIS STREET",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-388-6251",
            "fax_number": "304-388-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MAPLEWOOD AVENUE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708016",
            "telephone_number": "304-647-6006",
            "fax_number": "304-388-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMC GREENBRIER VALLEY MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMC GREENBRIER VALLEY MEDICAL CENTER INC",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "HOVIS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "304-388-6251",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

Verify at the official NPI Registry.