Valley Health Systems, Inc.

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

NPI 1659733293 · NPPES record last updated Mar 31, 2022

Key facts

NPI
1659733293
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
VALLEY HEALTH SYSTEMS, INC.
Practice address
6350 US Route 60 E
Barboursville, WV 25504
Phone
(304) 399-3350
Fax
(304) 697-2086
NPI assigned
Mar 23, 2016
Organization subpart
No

Authorized official

Name
Mary-Beth Brubeck
Title
Vice President of Finance / Cfo
Phone
(304) 525-3334

Other NPIs on the same Medicare enrollment 1

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

Practitioners 57

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

View all 57

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WV

Federally qualified health center certification: CCN 511098

Legal name
VALLEY HEALTH SYSTEMS, INC
Doing business as
VALLEY HEALTH FOODFAIR RT 60
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 18, 2016
Last certification
Apr 18, 2016
Ownership / control type
For profit – corporation
Organization structure
Other · Non-profit
Incorporated
Apr 13, 2016 in WV
Enrollment address
6350 US Route 60 E
Barboursville, WV 25504-1232

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Sherry Perry
Individual
Corporate Director
Member/Board of Directors
Feb 1, 1994
Christina Walter
Individual
Corporate Director
Member/Board of Directors
Apr 25, 2019
Steven Leigh Shattls
Individual
Corporate Officer
President/Ceo
Jan 1, 1975
W-2 Managing Employee Jan 1, 1975
Jared Colker
Individual
Corporate Director
Member/Board of Directors
Dec 8, 2016
Paulette Mabry
Individual
Corporate Director
Member/Board of Directors
Dec 8, 2016
Bill Bryant
Individual
Corporate Director
Member/Board of Directors
Apr 28, 2011
Suzi Brodof
Individual
Corporate Director
Member/Board of Directors
Oct 26, 2017
Sherrone Hornbuckle
Individual
Corporate Director
Member/Board of Directors
Oct 26, 2017
Mary-Beth Brubeck
Individual
Corporate Officer
VP of Finance/Cfo
Jan 1, 2019
W-2 Managing Employee Jan 1, 2019
Kalyn Obiozor Dorey
Individual
Corporate Director
Member/Board of Directors
Nov 22, 2022
Greg Agee
Individual
Corporate Director
Vice Chair/Board of Directors
Jan 27, 2005
Jill Hutchinson
Individual
Corporate Director
Chair/Board of Directors
Jan 27, 2005
Benjamin L Howard
Individual
Corporate Director
Member/Board of Directors
Jan 1, 2003

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Valley Health Apple Grove
Apple Grove, WV · CCN 581056
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 16, 1975
Valley Health SCP - Charleston 108
Charleston, WV · CCN 581062
Federally qualified health center Operational/Managerial Control Feb 1, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160511001131 WV Part a Provider - Federally Qualified Health Center (FQHC) 9931017969 Practice locations: Barboursville, WV
O20160824002521 WV Part B Supplier - Clinic/Group Practice 9931017969 Receives reassigned benefits from 56 practitioners
1 other NPI on this enrollment
Practice locations: Barboursville, WV

National Provider Directory

Locations

2585 3rd Ave
Huntington, WV 25703
Phone (304) 697-1396

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Yes
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X

Addresses

Primary practice location

6350 US Route 60 E
Barboursville, WV 25504

Mailing address

2585 3Rd Ave
Huntington, WV 25703-1642
Phone (304) 697-1396

Other names

  • Valley Health FoodFair Rt 60 Doing business as

Other providers in Barboursville, WV

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

Sources for this page

Verify at the official NPI Registry.