NPIMap

Organization Active NPI

Shenandoah Valley Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Berkeley Springs, WV
National Provider Identifier
1508064510
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SHENANDOAH VALLEY MEDICAL SYSTEM, INC.
Practice address
106 Sand Mine Rd Ste 7
Berkeley Springs, WV 25411-7457
Phone
(304) 263-7023
Fax
(304) 264-0508
NPI assigned
Jul 11, 2007
Last updated
Jul 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Michael Hassing
Title
Ceo
Phone
(304) 263-4999

Specialties & licenses 1

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

Addresses

Primary practice location

106 Sand Mine Rd Ste 7
Berkeley Springs, WV 25411-7457

Mailing address

PO Box 1146
Martinsburg, WV 25402-1146
Phone (304) 263-4999

Other identifiers 1

IdentifierTypeStateIssuer
3810008353MedicaidWV

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031119000556 WV Part B Supplier - Public Health/Welfare Agency 9739093097 Receives reassigned benefits from 34 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Berkeley Springs, WV; Charles Town, WV; Martinsburg, WV; Ranson, WV
O20051229000475 WV Part A Provider - Federally Qualified Health Center (FQHC) 9739093097 Practice locations: Berkeley Springs, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508064510. Details of each certification follow.

Federally qualified health center certification: CCN 581815

Legal name
SHENANDOAH VALLEY MEDICAL SYSTEM,INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 14, 2020
Last certification
Oct 14, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 7, 1976 in WV
Enrollment address
106 Sand Mine Rd
Ste 7
Berkeley Springs, WV 25411-7457

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 3

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

National Provider Directory

National Provider Directory

Locations

1644 Valley Rd
Berkeley Springs, WV 25411
Phone (304) 258-2000

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Pamela Parsons Individual Corporate Director May 6, 2024
Megan Holben Individual Corporate DirectorBoard Member Jul 1, 2024
Annley Nikki Bigiarelli Individual Corporate DirectorBoard of Directors Dec 5, 2022
John Charlton Individual Corporate OfficerSecretary Apr 3, 2023
Harold Shrewsberry Individual Corporate OfficerChairman of the Board Apr 3, 2023
Frank S Coe Individual Corporate OfficerTreasurer Jan 4, 2021
Jennifer Tolley Individual Corporate DirectorBoard Member Sep 5, 2023
Joseph Robinson Individual Corporate DirectorBoard Member Jun 3, 2024
Todd M Lockcuff Individual Corporate OfficerCeo Sep 1, 2025
W-2 Managing EmployeeCeo Sep 1, 2025 100%
Zachary Leach Individual Corporate OfficerVice Chair Nov 6, 2023

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": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1508064510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1146",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254021146",
            "telephone_number": "304-263-4999",
            "fax_number": "304-263-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SAND MINE RD STE 7",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "254117457",
            "telephone_number": "304-263-7023",
            "fax_number": "304-264-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH VALLEY MEDICAL SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "HASSING",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-263-4999"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810008353",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Springs, WV

Sources for this page

Verify at the official NPI Registry.