NPIMap

Organization Active NPI

Valley Health Systems Inc

Doing business as Valley Health Upper Kanawha

  • Federally Qualified Health Center (FQHC)
  • Cedar Grove, WV
National Provider Identifier
1699740472
Registry record updated Aug 2, 2018
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 Upper Kanawha
Practice address
408 Alexander Street
Cedar Grove, WV 25039
Phone
(304) 595-1770
NPI assigned
Feb 23, 2006
Last updated
Aug 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Authorized official

Name
Richard Weinberger
Title
Cfo
Phone
(304) 525-3334

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 3400 WV
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 11412 WV
Federally Qualified Health Center (FQHC) 261QF0400X WV Primary

Addresses

Primary practice location

408 Alexander Street
Cedar Grove, WV 25039

Mailing address

PO Box 1680
Huntington, WV 25717-1680

Other names 1

  • Valley Health Upper Kanawha Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20021230000015 WV Part A Provider - Federally Qualified Health Center (FQHC) 9931017969 Practice locations: Cedar Grove, WV
O20040325000411 WV Part B Supplier - Public Health/Welfare Agency 9931017969 Receives reassigned benefits from 154 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntington, WV; Wayne, WV; Ona, WV; Kermit, WV; Hurricane, WV; Harts, WV; Fort Gay, WV; Cedar Grove, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699740472. Details of each certification follow.

Federally qualified health center certification: CCN 511808

Legal name
VALLEY HEALTH SYSTEMS, INC
Doing business as
VALLEY HEALTH UPPER KANAWHA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
408 Alexander St
Cedar Grove, WV 25039

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Valley Health Sys Inc91 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2908 Auburn Rd
Huntington, WV 25704
Phone (304) 781-5800

Ownership & related parties

All disclosed owners & managing parties 14

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 Jan 1, 2010
Christina Walter Individual Corporate DirectorBoard Member Apr 25, 2019
Jared Colker Individual Corporate DirectorBoard Member Dec 8, 2016
Debra Zuberbuehler Individual Corporate DirectorBoard Member Jan 1, 2025
Paulette Mabry Individual Corporate DirectorBoard Member 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 Jan 23, 1983
Mary-Beth Brubeck Individual Corporate OfficerExecutive Vice President / Cfo Jan 1, 2019
Kalyn Obiozor Dorey Individual Corporate DirectorBoard Member Nov 22, 2022
Greg Agee Individual Corporate DirectorBoard Member Jan 27, 2005
Xavier Staggs Individual Corporate DirectorBoard Member Jan 1, 2025
Benjamin L Howard Individual Corporate DirectorBoard Member Jan 1, 2010

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 5

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": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1699740472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 ALEXANDER STREET",
            "city": "CEDAR GROVE",
            "state": "WV",
            "postal_code": "25039",
            "telephone_number": "304-595-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "WEINBERGER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "304-525-3334"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WV",
            "license": "3400",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "11412",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Upper Kanawha",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health Upper Kanawha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Grove, WV

Sources for this page

Verify at the official NPI Registry.