NPIMap

Organization Active NPI

E. a. Hawse Health Center, Inc.

Doing business as Ice Mountain Elementary School

  • Federally Qualified Health Center (FQHC)
  • Slanesville, WV
National Provider Identifier
1609757491
Registry record updated Sep 9, 2025
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
Ice Mountain Elementary School
Practice address
6650 Bloomery Pike
Slanesville, WV 25444
Phone
(304) 897-5915
NPI assigned
Sep 9, 2025
Last updated
Sep 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

6650 Bloomery Pike
Slanesville, WV 25444

Mailing address

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

Other names 1

  • ICE MOUNTAIN ELEMENTARY SCHOOL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251023000879 WV Part A Provider - Federally Qualified Health Center (FQHC) 6204728041 Practice locations: Slanesville, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609757491. Details of each certification follow.

Federally qualified health center certification: CCN 581077

Legal name
E. A. HAWSE HEALTH CENTER, INC.
Doing business as
ICE MOUNTAIN ELEMENTARY SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 20, 2025
Last certification
Oct 20, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
6650 Bloomery Pike
Slanesville, WV 25444-3223

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

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

Ownership & related parties

All disclosed owners & managing parties 15

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 OfficerBoard Secretary Feb 1, 2020
John Hunter Williams Individual Corporate Director Nov 1, 2024
Joann Kuhn Individual Corporate Director Oct 1, 2019
Michael Funkhouser Individual Corporate OfficerBoard President Sep 1, 2022
Imogen Helsley Individual Corporate Director Feb 1, 2023
Ralph Fitzwater Individual Corporate Director Dec 1, 2019
Christopher Hahn Individual Corporate OfficerCfo Mar 1, 2025
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 OfficerBoard Treasurer Jun 1, 2020
Melissa Thompson Individual Contracted Managing EmployeeCeo Dec 1, 2019
Corporate OfficerCeo Dec 1, 2019
Tracey Ratliff Individual Corporate Director Oct 1, 2009
Regina Whetzel Individual Corporate OfficerBoard Vice President Nov 1, 2011

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1609757491",
    "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": "6650 BLOOMERY PIKE",
            "city": "SLANESVILLE",
            "state": "WV",
            "postal_code": "25444",
            "telephone_number": "304-897-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. A. HAWSE HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-08-25",
        "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": "ICE MOUNTAIN ELEMENTARY SCHOOL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Slanesville, WV

Sources for this page

Verify at the official NPI Registry.