NPIMap

Organization Active NPI

E. a. Hawse Health Center, Inc.

Doing business as E. A. Hawse Health Center, Inc.-Love Clinic

  • Federally Qualified Health Center (FQHC)
  • Moorefield, WV
National Provider Identifier
1487428009
Registry record updated Nov 14, 2023
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.
Doing business as
E. A. Hawse Health Center, Inc.-Love Clinic
Practice address
112 Kuykendall LN
Moorefield, WV 26836-1167
Phone
(304) 897-5915
NPI assigned
Nov 14, 2023
Last updated
Nov 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Authorized official

Name
Melissa Thompson
Title
Ceo
Phone
(304) 897-5915

Specialties & licenses 1

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

Addresses

Primary practice location

112 Kuykendall LN
Moorefield, WV 26836-1167

Mailing address

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

Other names 1

  • E. A. Hawse Health Center, Inc.-Love Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240820002562 WV Part A Provider - Federally Qualified Health Center (FQHC) 6204728041 Practice locations: Moorefield, WV
O20241119003433 WV Part B Supplier - Clinic/Group Practice 6204728041 Practice locations: Moorefield, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487428009. Details of each certification follow.

Federally qualified health center certification: CCN 581048

Legal name
E. A. HAWSE HEALTH CENTER, INC.
Doing business as
E. A. HAWSE HEALTH CENTER, INC.-LOVE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 14, 2024
Last certification
Aug 14, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
112 Kuykendall LN
Moorefield, WV 26836-1167

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2295419Ea Hawse Health Center, Inc Love Clinic112 Kuykendall Lane, Moorefield, WV 26836Provider-performed microscopyDec 11, 2027

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

111 S Grove St
Ste 1
Petersburg, WV 26847
Phone (304) 257-2451

Ownership & related parties

All disclosed owners & managing parties 14

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 1, 2001
Joann Kuhn Individual Corporate Director Oct 1, 2019
Michael Funkhouser Individual Corporate Director Sep 1, 2022
Imogen Helsley Individual Corporate Director Feb 1, 2023
Ralph Fitzwater Individual Corporate OfficerBoard President Dec 1, 2019
John Treadway Individual Corporate Director Feb 1, 2023
Cheryl L Sherman Individual Operational/Managerial ControlBilling Supervisor Jan 1, 2019
Stacey Heavner Individual Corporate Director Dec 1, 2009
Kristopher Kerr Individual Corporate Director May 1, 2016
David Mayfield Individual Corporate OfficerTreasurer Jun 1, 2020
Melissa Thompson Individual Contracted Managing EmployeeCeo Dec 1, 2019
Corporate OfficerCeo Jan 1, 2019
Tracey Ratliff Individual Corporate Director Oct 1, 2009
Regina Whetzel Individual Corporate OfficerVice President Nov 1, 2011

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1487428009",
    "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": "112 KUYKENDALL LN",
            "city": "MOOREFIELD",
            "state": "WV",
            "postal_code": "268361167",
            "telephone_number": "304-897-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. A. HAWSE HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CEO",
        "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.-Love Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moorefield, WV

Sources for this page

Verify at the official NPI Registry.