Valley Health Systems, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

VALLEY HEALTH SYSTEMS, INC.

Doing business as

Valley Health Teays Pediatrics

Practice address

111 Great Teays Blvd
Scott Depot, WV 25560-9548

Phone

(304) 757-8459

Fax

(304) 525-3338

NPI assigned

Jun 19, 2019

Last updated

Jun 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary-Beth Brubeck

Title

Cfo

Phone

(304) 525-3334

Specialties & licenses 2

Addresses

Other names 1

• Valley Health Teays Pediatrics Doing business as

Medicare fee-for-service enrollment

Enrolled in WV2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700446929. Details of each certification follow.

• CCN 511174 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 511174

Legal name

VALLEY HEALTH SYSTEMS, INC

Doing business as

VALLEY HEALTH TEAYS PEDIATRICS

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 4, 2019

Last certification

Oct 4, 2019

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Oct 4, 2019 in WV

Enrollment address

111 Great Teays Blvd
Scott Depot, WV 25560-9548

Other NPIs on the same Medicare enrollment 1

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

• Valley Health Systems, Inc.

  dba Valley Health - Fee for Service

  • Clinic/Center
  • Huntington, WV
  • NPI 1659252591

  O20191202000085

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

Owners & managing parties with NPI records 1

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

• Mathew Benjamin Weimer, MD

  • Family Medicine Physician
  • Milton, WV
  • NPI 1245444074

  Corporate Officer, W-2 Managing Employee

  CMS ownership

All facility ownership & control disclosures 2

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

Practitioners 37

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.

• Sierra Michele Adkins, FNP-BC

  • Family Nurse Practitioner
  • Fort Gay, WV
  • NPI 1861181182
  Medicare reassignment NPD
• Jessica Allen, APRN-FNP-BC

  • Family Nurse Practitioner
  • Scott Depot, WV
  • NPI 1184179095
  Medicare reassignment NPD
• John David Apgar, DO

  • Family Medicine Physician
  • Huntington, WV
  • NPI 1740845056
  Medicare reassignment NPD
• Megan M Bartram, MD

  • Pediatrics Physician
  • Huntington, WV
  • NPI 1972731396
  Medicare reassignment NPD
• Brandi Jay Blake, FNP-BC

  • Family Nurse Practitioner
  • Huntington, WV
  • NPI 1538884713
  Medicare reassignment NPD
• Matthew Q Christiansen, MD

  • Family Medicine Physician
  • Huntington, WV
  • NPI 1568807592
  Medicare reassignment NPD
• Ryan R Cicenas, MD

  • Internal Medicine Physician
  • Scott Depot, WV
  • NPI 1679539522

  Pediatrics

  Medicare reassignment NPD
• Alexandra Nicole Collins, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Wayne, WV
  • NPI 1518605765
  Medicare reassignment NPD
• Hannah Aspy Conley, PA-C

  • Physician Assistant
  • Scott Depot, WV
  • NPI 1326394263
  Medicare reassignment NPD
• Rebecca Marie Denning, PSYD

  • Clinical Psychologist
  • Huntington, WV
  • NPI 1528291416
  Medicare reassignment NPD
• Jody Frazier

  • Family Nurse Practitioner
  • Huntington, WV
  • NPI 1700258191
  Medicare reassignment NPD
• Jessica Leigh Holley, APRN

  • Family Nurse Practitioner
  • Hurricane, WV
  • NPI 1932971538
  Medicare reassignment NPD

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560902400000",
    "number": "1700446929",
    "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": "111 GREAT TEAYS BLVD",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609548",
            "telephone_number": "304-757-8459",
            "fax_number": "304-525-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-06-19",
        "status": "A",
        "authorized_official_last_name": "BRUBECK",
        "authorized_official_first_name": "MARY-BETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "304-525-3334"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Teays Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teays Valley Volunteer Fire Department Inc
• Morgan Elizabeth Teeters, MS RDN LD CLC
• Breann Hawley Thomas, WHNP-BC
• Megan Tolbert
• Valley Chiropractic PLLC
• Kristina Vannoy
• Alyssa Vanoy
• Cynthia Varney
• Nathan Andrew Vaughan, MD
• Megan Vogel, PHARMD

• Federally Qualified Health Center (FQHC) in Scott Depot, WV
• Providers in Scott Depot, WV by specialty
• 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 19, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.