NPIMap

Organization Active NPI

Camc Greenbrier Valley Medical Center Inc

  • General Acute Care Hospital
  • Ronceverte, WV
National Provider Identifier
1679299408
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
CAMC GREENBRIER VALLEY MEDICAL CENTER INC
Practice address
1320 Maplewood Ave
Ronceverte, WV 24970-8016
Phone
(304) 647-6006
Fax
(304) 388-6782
NPI assigned
Oct 13, 2022
Last updated
Oct 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Authorized official

Name
Mr. Chad Hovis
Title
VP Finance
Phone
(304) 388-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

1320 Maplewood Ave
Ronceverte, WV 24970-8016

Mailing address

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-6251

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230117001078 WV Part A Provider - Hospital 1254702962 Practice locations: Lewisburg, WV; Peterstown, WV; Rainelle, WV; Ronceverte, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679299408. Details of each certification follow.

Hospital certification: CCN 510002

Legal name
CAMC GREENBRIER VALLEY MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 24, 1970
Last certification
Dec 13, 2006
Beds
122
Ownership / control type
Private (for profit)
Most recent change of ownership
Jan 1, 2023 (2 total)
Organization structure
CorporationProprietary
Enrollment address
1320 Maplewood Ave
Ronceverte, WV 24970-8016
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Camc Greenbrier Valley Medical Center, IncCCN 510002 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Camc Greenbrier Valley Medical Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Glenn Crotty Individual Corporate DirectorVice President Jan 1, 2023
David L Ramsey Individual Corporate DirectorPresident Jan 1, 2023
Chad Hovis Individual Corporate DirectorVP of Finance Jan 1, 2023
W-2 Managing EmployeeVP of Finance Jan 1, 2023
Vandalia Health Inc Organization, Charleston, WV Corporation 5% Or Greater Direct Ownership Interest Sep 1, 2022 100%
Operational/Managerial Control Sep 1, 2022 100%
Jeffrey D Sandene Individual Corporate DirectorTreasurer Jan 1, 2023
W-2 Managing EmployeeTreasurer Jan 1, 2023

Owners & managing parties with NPI records 1

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

Facilities with the same owner 17

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 17

Practitioners & affiliated clinicians

Practitioners 21

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 21

Affiliated clinicians 267

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 267

NPI Registry JSON

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1679299408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-388-6251",
            "fax_number": "304-388-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MAPLEWOOD AVE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708016",
            "telephone_number": "304-647-6006",
            "fax_number": "304-388-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMC GREENBRIER VALLEY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "HOVIS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "304-388-6251",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

Verify at the official NPI Registry.