NPIMap

Organization Active NPI

Wirt County Health Services Association Inc

  • Federally Qualified Health Center (FQHC)
  • Parkersburg, WV
National Provider Identifier
1497484091
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WIRT COUNTY HEALTH SERVICES ASSOCIATION INC
Practice address
73 Nicolette Rd
Parkersburg, WV 26104
Phone
(304) 861-4141
NPI assigned
Jun 8, 2022
Organization subpart
Yes
Parent organization
WIRT COUNTY HEALTH SERVICES ASSOCIATION INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Authorized official

Name
Vicki Lynn Knicely
Title
Revenue Cycle Manager
Phone
(304) 275-3301

Specialties & licenses 1

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

Addresses

Primary practice location

73 Nicolette Rd
Parkersburg, WV 26104

Mailing address

PO Box 609
Elizabeth, WV 26143-0609
Phone (304) 275-3301

Other names 1

  • West Virginia University at Parkersburg Health and Wellness Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210712001019 WV Part B Supplier - Clinic/Group Practice 7810806577 Receives reassigned benefits from 27 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Parkersburg, WV
O20220911000042 WV Part A Provider - Federally Qualified Health Center (FQHC) 7810806577 Practice locations: Parkersburg, WV

Federally qualified health center certification: CCN 581841

Legal name
WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 31, 2022
Last certification
Oct 31, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 17, 1978 in WV
Enrollment address
73 Nicolette Rd
Parkersburg, WV 26104

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Wirt County Health SVC Assoc Inc

Locations

483 Court St
Elizabeth, WV 26143
Phone (304) 275-3301

73 Nicolette Rd
Parkersburg, WV 26104
Phone (304) 861-4141

2101 Dudley Ave
Parkersburg, WV 26101
Phone (304) 488-3610

512A Church St S
Ripley, WV 25271
Phone (304) 372-1033

562 Charleston Dr
Ripley, WV 25271
Phone (304) 372-7341

194 Pinnell St
Bldg 8
Ripley, WV 25271
Phone (304) 373-1632

194 Pinnell St
#8
Ripley, WV 25271
Phone (304) 373-1632

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Donald Brookover Individual Corporate DirectorBoard Member Jul 1, 1978
Doug Ritchie Individual Corporate DirectorBoard Member Aug 1, 2020
Treva Full Individual Corporate DirectorBoard Member Feb 1, 2010
Chris Shoop Individual Corporate DirectorBoard Member Jun 1, 2019
Berkley Simmons Individual Corporate DirectorBoard Member Dec 1, 2014
Bruce Dewees Individual Corporate DirectorBoard Member Jun 1, 2019
Kathy G Taylor Individual Corporate DirectorBoard Member Jun 1, 2019
James Frazier Individual Corporate DirectorBoard Member Aug 1, 2011
Melissa Weekley Individual Corporate DirectorBoard Member Jul 1, 2013
David M Schenkelberg Individual Corporate DirectorBoard Member Aug 1, 2013
Gwen Crum Individual Corporate DirectorBoard Member Jun 1, 2019
Charles Hasse Individual Corporate DirectorBoard Member Jun 1, 2019
Judy Cline Individual Corporate DirectorBoard Member Jul 1, 2000
Vicki Knicely Individual W-2 Managing EmployeeBilling Coordinator Mar 25, 2002
Douglas Full Individual Corporate DirectorBoard Member Jul 1, 2013
Greg Reed Individual Corporate DirectorBoard Member Jun 1, 2019
Rob Dudley Individual Corporate OfficerCeo Sep 8, 2018

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ripley Family MedicineRipley, WV, CCN 511933 Federally qualified health center Operational/Managerial Control Jul 17, 1978
Wirt County Health Services Association, IncParkersburg, WV, CCN 581818 Federally qualified health center Operational/Managerial Control Oct 13, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1497484091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "ELIZABETH",
            "state": "WV",
            "postal_code": "261430609",
            "telephone_number": "304-275-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 NICOLETTE RD",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "26104",
            "telephone_number": "304-861-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIRT COUNTY HEALTH SERVICES ASSOCIATION INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WIRT COUNTY HEALTH SERVICES ASSOCIATION INC",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "KNICELY",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "304-275-3301"
    },
    "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": "West Virginia University at Parkersburg Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.