NPIMap

Organization Active NPI

New River Health Association, Inc.

Doing business as Independence Middle School Based Health Cen

  • Federally Qualified Health Center (FQHC)
  • Coal City, WV
National Provider Identifier
1699260224
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEW RIVER HEALTH ASSOCIATION, INC.
Doing business as
Independence Middle School Based Health Cen
Practice address
800 Independence Road
Coal City, WV 25823
Phone
(304) 469-2905
Fax
(304) 469-2981
NPI assigned
Jun 26, 2018
Last updated
Oct 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
John R. Schultz
Title
Chief Executive Officer
Phone
(304) 465-2258

Specialties & licenses 1

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

Addresses

Primary practice location

800 Independence Road
Coal City, WV 25823

Mailing address

497 Mall Rd
Oak Hill, WV 25901-6216
Phone (304) 469-2905

Other names 1

  • Independence Middle School Based Health Cen Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181207001065 WV Part A Provider - Federally Qualified Health Center (FQHC) 2365348596 Practice locations: Coal City, WV
O20190412001756 WV Part B Supplier - Clinic/Group Practice 2365348596 Receives reassigned benefits from 3 practitioners
Practice locations: Sophia, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699260224. Details of each certification follow.

Federally qualified health center certification: CCN 511161

Legal name
NEW RIVER HEALTH ASSOCIATION INC
Doing business as
INDEPENDENCE MIDDLE SCHOOL BASED HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 26, 2018
Last certification
Nov 26, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 27, 1976 in WV
Enrollment address
800 Independence Road
Coal City, WV 25823

Other NPIs with the same Medicare PAC ID 21

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

View all 21

National Provider Directory

National Provider Directory
Tax ID family
New River Family HLTH C9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Angela M Barker Individual Corporate DirectorMedical Director Feb 1, 2014
W-2 Managing EmployeeMedical Director Feb 1, 2014
Sharon Bradley Individual Corporate OfficerBoard Member May 1, 2015 7%
Nathan Hollister Individual Corporate Officer Jan 1, 2020
Marissa Johnson Individual W-2 Managing Employee Jan 7, 2019
New River Health Association Inc Organization, Coal City, WV Corporation, Medical provider/supplier, Non-profit 5% Or Greater Direct Ownership Interest Jun 26, 2018 100%
Operational/Managerial Control Jun 26, 2018 100%
Robert Simmons Individual Corporate OfficerVice Chair-Board Member Jul 1, 2018
Paul Lively Individual Corporate OfficerBoard Member Jul 1, 1978 7%
Rose Michaels Individual Corporate OfficerBoard Member-Sec Nov 1, 2014
Gabriel Pena Individual Corporate OfficerBoard Member-1St Chair Nov 11, 2013
Michele Sarrett Individual Corporate Officer Feb 25, 2025
John R Schultz Individual Corporate OfficerChief Executive Officer Jan 7, 2013
Corporate DirectorChief Executive Officer Jan 7, 2013
W-2 Managing EmployeeChief Executive Officer Jan 7, 2013 8%
Evelyn Hizer Individual Corporate OfficerBoard Member Jul 1, 1995
Mark V Sundstrom Individual Corporate Officer Jun 30, 2023
Steve Pawlus Individual Corporate Officer Aug 27, 2020
Daniel B Doyle Individual Corporate Officer Mar 17, 2026
Angela Sundstrom Individual Corporate OfficerBoard Member Feb 1, 2016 7%
Gary Hairston Individual Corporate OfficerBoard Member Sep 1, 2012 7%

Owners & managing parties with NPI records 23

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

View all 23

All facility ownership & control disclosures 10

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

FacilityTypeRoleSince
New River Health - SophiaSophia, WV, CCN 511956 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 27, 1976
New River Intermediate School Based Health CenterOak Hill, WV, CCN 511963 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 27, 1976
Oak Hill High School Based Health CenterOak Hill, WV, CCN 511962 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 27, 1976
Nicholas County School Based Health CenterSummersville, WV, CCN 511965 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 27, 1976
Coal City Elementary School Based Health CenterCoal City, WV, CCN 511969 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 27, 1976
Independence School Based Health CenterCoal City, WV, CCN 511970 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 27, 1976
New River Health - SummersvilleSummersville, WV, CCN 511124 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 1, 2017
Fayetteville PK-8 School Based Health CenterFayetteville, WV, CCN 511179 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 27, 1976
New River Health - SmithersSmithers, WV, CCN 511189 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 27, 1976
New River Health - Oak HillOak Hill, WV, CCN 581809 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 27, 1976

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 10

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

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1699260224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 MALL RD",
            "city": "OAK HILL",
            "state": "WV",
            "postal_code": "259016216",
            "telephone_number": "304-469-2905",
            "fax_number": "304-465-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 INDEPENDENCE ROAD",
            "city": "COAL CITY",
            "state": "WV",
            "postal_code": "25823",
            "telephone_number": "304-469-2905",
            "fax_number": "304-469-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW RIVER HEALTH ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "304-465-2258"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Independence Middle School Based Health Cen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coal City, WV

Sources for this page

Verify at the official NPI Registry.