Community Health Systems Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COMMUNITY HEALTH SYSTEMS INC.

Practice address

8965 Shoestring Trail
Williamsburg, WV 24991-0010

Phone

(304) 645-7872

Fax

(304) 645-7873

NPI assigned

Apr 4, 2016

Organization subpart

No

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

Authorized official

Name

Charles Hunt

Title

Ceo

Phone

(304) 252-8324

Specialties & licenses 2

Addresses

Other names 1

• AccessHealth-Northern Greenbrier Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in WV2 enrollments

Enrollment records 2

Federally qualified health center certification: CCN 511099

Legal name

COMMUNITY HEALTH SYSTEMS INC

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

CorporationNon-profit

Enrollment address

8965 Shoestring TRL
Williamsburg, WV 24991-9743

All disclosed owners & managing parties 1

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

All facility ownership & control disclosures 6

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

Practitioners 1

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

• Jesse R. Chaffin, MD

  • Family Medicine Physician
  • Williamsburg, WV
  • NPI 1386025310

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1669835989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013503",
            "telephone_number": "304-252-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8965 SHOESTRING TRAIL",
            "city": "WILLIAMSBURG",
            "state": "WV",
            "postal_code": "249910010",
            "telephone_number": "304-645-7872",
            "fax_number": "304-645-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH SYSTEMS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-252-8324"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AccessHealth-Northern Greenbrier Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marla Bell
• Tara Butcher
• Rebecca Cayton
• Jesse R. Chaffin, MD
• Michelle Daily
• Debra Elizabeth Johnson
• Sarah McFerrin
• Northern Greenbrier Health Clinic, Inc
• Timothy Dean Stafford

• All providers in Williamsburg, WV
• Federally Qualified Health Center (FQHC) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.