NPIMap

Organization Active NPI

Page Memorial Hospital Inc.

Doing business as Valley Health Page Memorial Hospital Family Medicine- Stanley

  • Rural Health Clinic/Center
  • Stanley, VA
National Provider Identifier
1598779571
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PAGE MEMORIAL HOSPITAL INC.
Doing business as
Valley Health Page Memorial Hospital Family Medicine- Stanley
Practice address
235 Medical Dr
Stanley, VA 22851-4112
Phone
(540) 778-1249
Fax
(540) 743-9560
NPI assigned
Jul 28, 2006
Last updated
Feb 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Renee Nevada Johnson
Title
Credentialing Coordinator
Phone
(540) 536-0103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X VA Primary

Addresses

Primary practice location

235 Medical Dr
Stanley, VA 22851-4112

Mailing address

220 Campus Blvd Ste 100
Winchester, VA 22601-2896

Other identifiers 1

IdentifierTypeStateIssuer
007610181MedicaidVA

Other names 1

  • Valley Health Page Memorial Hospital Family Medicine- Stanley Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040129000420 VA Part B Supplier - Clinic/Group Practice 8426951203 Receives reassigned benefits from 386 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stanley, VA; Shenandoah, VA; Luray, VA; Front Royal, VA
O20101109001303 VA Part A Provider - Rural Health Clinic 8426951203 Practice locations: Stanley, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598779571. Details of each certification follow.

Rural health clinic certification: CCN 493987

Legal name
PAGE MEMORIAL HOSPITAL INC
Doing business as
VALLEY HEALTH PAGE MEMORIAL HOSPITAL FAMILY MEDICINE STANLEY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 1, 1995
Last certification
Jan 17, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 17, 1925 in VA
Enrollment address
235 Medical Dr
Stanley, VA 22851-4112
Related CCNs
491307

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 11

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

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
49D0899887Valley Health Page Memorial Hospital235 Medical Drive, Stanley, VA 22851Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Page Memorial Hosptial7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Nelson T Clark Individual Corporate Director Dec 31, 2008
W-2 Managing Employee Dec 31, 2008
Valley Health System Organization, Winchester, VA Corporation 5% Or Greater Direct Ownership Interest Dec 31, 2008
Jill Chambers Individual W-2 Managing Employee Sep 1, 2017

Facilities with the same owner 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 9

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": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1598779571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MEDICAL DR",
            "city": "STANLEY",
            "state": "VA",
            "postal_code": "228514112",
            "telephone_number": "540-778-1249",
            "fax_number": "540-743-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGE MEMORIAL HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-02-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "NEVADA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "540-536-0103"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007610181",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Page Memorial Hospital Family Medicine- Stanley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health Page Memorial Hospital Family Medicine- Stanley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stanley, VA

Sources for this page

Verify at the official NPI Registry.