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Community Health Systems Inc

Organization Active NPI Family Medicine Physician · Daniels, WV

NPI 1528618907 · NPPES record last updated Sep 17, 2019

Key facts

NPI
1528618907
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
COMMUNITY HEALTH SYSTEMS INC
Practice address
351 4H Lake Rd
Daniels, WV 25832-9531
Phone
(681) 238-0644
NPI assigned
Sep 17, 2019
Organization subpart
No

Authorized official

Name
Charles Hunt
Title
Ceo
Phone
(304) 252-8324

Corporate family (same tax ID) 43

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

View all 43

Facilities with the same owner 5

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

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WV

Federally qualified health center certification: CCN 511180

Legal name
COMMUNITY HEALTH SYSTEMS INC
Doing business as
ACCESSHEALTH DANIELS ELEMENTARY SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 19, 2020
Last certification
Mar 19, 2020
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
351 4H Lake Rd
Daniels, WV 25832-9531

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Larry Misiti
Individual 		Corporate Officer
Board Member		 Sep 1, 2018
Carl Bowman
Individual 		Corporate Officer
Board Member		 Jun 1, 2015
Maura Johnson
Individual 		Corporate Officer
Board Member		 Jun 1, 2013
Community Health Systems Inc
Organization · Beckley, WV
Non-profit 		Operational/Managerial Control Apr 17, 2000
Gregory Hazuka
Individual 		Corporate Officer
Board Member		 Jun 5, 2006
Roger Fox
Individual 		Corporate Officer
Board Member		 Sep 1, 2018
Charles Hunt
Individual 		Corporate Officer
Ceo		 Apr 17, 2000
W-2 Managing Employee
Ceo		 Apr 19, 2000
Operational/Managerial Control Apr 17, 2000

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Access Health
Welch, WV · CCN 511151		 Federally qualified health center Operational/Managerial Control Aug 25, 2017
Community Health Systems Inc
Beckley, WV · CCN 511159		 Federally qualified health center Operational/Managerial Control Oct 1, 2018
Accesshealth
Beckley, WV · CCN 511175		 Federally qualified health center Operational/Managerial Control Aug 1, 2019
Community Health Systems Inc
Beckley, WV · CCN 581840		 Federally qualified health center Operational/Managerial Control Apr 17, 2000
Accesshealth Stratton Elementary
Beckley, WV · CCN 581072		 Federally qualified health center Operational/Managerial Control Oct 31, 2023

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200319002921 WV Part a Provider - Federally Qualified Health Center (FQHC) 6608785795 Practice locations: Daniels, WV

National Provider Directory

Tax ID family
Community Health System (44 organizations share this tax ID)

Locations

351 4H Lake Rd
Daniels, WV 25832
Phone (304) 877-8215

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

351 4H Lake Rd
Daniels, WV 25832-9531

Mailing address

252 Rural Acres Dr
Beckley, WV 25801-3503
Phone (304) 252-8324

Other names

  • AccessHealth Daniels Elementary School-Based Clinic Doing business as

Other providers in Daniels, WV

All providers in Daniels, WV · Family Medicine Physician in West Virginia

Sources for this page

Verify at the official NPI Registry.