NPIMap

Organization Active NPI

Valley Health Systems, Inc.

Doing business as Valley Health Teays Valley

  • Federally Qualified Health Center (FQHC)
  • Hurricane, WV
National Provider Identifier
1659769776
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VALLEY HEALTH SYSTEMS, INC.
Doing business as
Valley Health Teays Valley
Practice address
1100 Hospital Dr
Hurricane, WV 25526
Phone
(304) 757-8683
Fax
(304) 757-8684
NPI assigned
Dec 23, 2014
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

1100 Hospital Dr
Hurricane, WV 25526

Mailing address

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

Other names 1

  • Valley Health Teays Valley Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150326000182 WV Part A Provider - Federally Qualified Health Center (FQHC) 9931017969 Practice locations: Hurricane, WV
O20151015002625 WV Part B Supplier - Clinic/Group Practice 9931017969 Receives reassigned benefits from 52 practitioners
1 other NPI on this enrollment
Practice locations: Hurricane, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659769776. Details of each certification follow.

Federally qualified health center certification: CCN 511073

Legal name
VALLEY HEALTH SYSTEMS, INC
Doing business as
VALLEY HEALTH TEAYS VALLEY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 26, 2015
Last certification
Mar 26, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 2015 in WV
Enrollment address
1100 Hospital Dr
Hurricane, WV 25526-8712

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

1100 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-8683

Ownership & related parties

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 DirectorBoard Member Feb 1, 1994
Christina Walter Individual Corporate DirectorBoard Members Apr 25, 2019
Jared Colker Individual Corporate DirectorBoard Member Dec 8, 2016
Paulette Mabry Individual Corporate Director Dec 8, 2016
Bill Bryant Individual Corporate DirectorBoard Member Apr 28, 2011
Suzi Brodof Individual Corporate DirectorBoard Member Oct 26, 2017
Mathew Weimer Individual Corporate OfficerPresident, Ceo Sep 28, 2024
W-2 Managing Employee Sep 28, 2024
Sherrone Hornbuckle Individual Corporate DirectorBoard Member Oct 26, 2017
Mary-Beth Brubeck Individual Corporate OfficerVice President of Finance / Cfo Jan 1, 2019
Corporate DirectorVice President of Finance / Cfo Jan 1, 2019
W-2 Managing EmployeeVice President of Finance / Cfo Jan 1, 2019
Kalyn Obiozor Dorey Individual Corporate DirectorBoard Member Nov 22, 2022
Greg Agee Individual Corporate DirectorBoard Member Jan 27, 2005
Jill Hutchinson Individual Corporate DirectorBoard Member Jan 27, 2005
Benjamin L Howard Individual Corporate DirectorBoard Member Jan 1, 2003

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

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

Practitioners & affiliated clinicians

Practitioners 53

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.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1659769776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031642",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HOSPITAL DR",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "25526",
            "telephone_number": "304-757-8683",
            "fax_number": "304-757-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "BRUBECK",
        "authorized_official_first_name": "MARY-BETH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE / CFO",
        "authorized_official_telephone_number": "304-525-3334"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Teays Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health Teays Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hurricane, WV

Sources for this page

Verify at the official NPI Registry.