E. a. Hawse Health Center, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Slanesville, WV

NPI 1609757491 · NPPES record last updated Sep 9, 2025

Key facts

NPI
1609757491
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
E. A. HAWSE HEALTH CENTER, INC.
Practice address
6650 Bloomery Pike
Slanesville, WV 25444
Phone
(304) 897-5915
NPI assigned
Sep 9, 2025
Organization subpart
No

Authorized official

Name
Melissa Thompson
Title
Ceo
Phone
(304) 897-5915

Other NPIs with the same Medicare PAC ID 17

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

Corporate family (same tax ID) 23

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

Practitioners 19

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 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
Corporation · Non-profit
Enrollment address
6650 Bloomery Pike
Slanesville, WV 25444-3223

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 Officer
Board 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 Officer
Board President
Sep 1, 2022
Imogen Helsley
Individual
Corporate Director Feb 1, 2023
Ralph Fitzwater
Individual
Corporate Director Dec 1, 2019
Christopher Hahn
Individual
Corporate Officer
Cfo
Mar 1, 2025
John Treadway
Individual
Corporate Director Feb 1, 2023
Cheryl L Sherman
Individual
Operational/Managerial Control
Billing Supervisor
Jan 1, 2019
Stacey Heavner
Individual
Corporate Director Dec 1, 2009
Kristopher Kerr
Individual
Corporate Director May 1, 2016
David Mayfield
Individual
Corporate Officer
Board Treasurer
Jun 1, 2020
Melissa Thompson
Individual
Contracted Managing Employee
Ceo
Dec 1, 2019
Corporate Officer
Ceo
Dec 1, 2019
Tracey Ratliff
Individual
Corporate Director Oct 1, 2009
Regina Whetzel
Individual
Corporate Officer
Board Vice President
Nov 1, 2011

Medicare enrollment records

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

National Provider Directory

Tax ID family
E a Hawse Health Center Inc (24 organizations share this tax ID)

Specialties & licenses

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

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

  • ICE MOUNTAIN ELEMENTARY SCHOOL Doing business as

Other providers in Slanesville, WV

All providers in Slanesville, WV · Federally Qualified Health Center (FQHC) in West Virginia

Sources for this page

Verify at the official NPI Registry.