Valley Health Systems Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Kermit, WV
NPI 1720054489 · NPPES record last updated Mar 31, 2022
Key facts
- NPI
- 1720054489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- VALLEY HEALTH SYSTEMS INC
- Practice address
- 3 Adena Dr
Kermit, WV 25674-8063 - Phone
- (304) 393-4090
- Fax
- (304) 393-4091
- NPI assigned
- Feb 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Mary-Beth Brubeck
- Title
- Vice President of Finance / Cfo
- Phone
- (304) 525-3334
Owners & managing parties with NPI records 1
Other NPIs on the same Medicare enrollment 15
Practitioners 2
-
Sierra Michele Adkins, FNP-BC
-
Lisa Smith, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
Federally qualified health center certification: CCN 511846
- Legal name
- VALLEY HEALTH SYSTEMS, INC
- Doing business as
- STEPPTOWN COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Aug 16, 1994
- Last certification
- Aug 16, 1994
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 1, 1975 in WV
- Enrollment address
- 3 Adena Dr
Kermit, WV 25674-8063 - Related CCNs
- 511803
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Sherry Perry |
Corporate Director |
Jun 16, 2003 | |
| Christina Walter |
Corporate Director |
Apr 25, 2019 | |
| Jared Colker |
Corporate Director |
Dec 8, 2016 | |
| Debra Zuberbuehler |
Corporate Director |
Jan 1, 2025 | |
| Paulette Mabry |
Corporate Director |
Dec 8, 2016 | |
| Bill Bryant |
Corporate Director |
Apr 28, 2011 | |
| Suzi Brodof |
Corporate Director |
Oct 26, 2017 | |
| Mathew Weimer |
Corporate Officer |
Sep 28, 2024 | |
| W-2 Managing Employee | Sep 28, 2024 | ||
| Sherrone Hornbuckle |
Corporate Director |
Oct 26, 2017 | |
| Mary-Beth Brubeck |
Corporate Officer |
Jan 1, 2019 | |
| W-2 Managing Employee |
Jan 1, 2019 | ||
| Kalyn Obiozor Dorey |
Corporate Director | Nov 22, 2022 | |
| Greg Agee |
Corporate Director |
Jan 27, 2005 | |
| Xavier Staggs |
Corporate Director |
Jan 1, 2025 | |
| Benjamin L Howard |
Corporate Director |
Jun 16, 2003 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Valley Health Apple Grove |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 16, 1975 |
| Valley Health SCP - Charleston 108 |
Federally qualified health center | Operational/Managerial Control | Feb 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030616000031 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 9931017969 | Practice locations: Kermit, 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | |||
| Family Medicine Physician |
207Q00000X | 19741 | WV | |
| Federally Qualified Health Center (FQHC) | 261QF0400X | WV | Yes | |
| Nurse Practitioner |
363L00000X | WV |
Addresses
Primary practice location
3 Adena Dr
Kermit, WV 25674-8063
Mailing address
2585 3Rd Ave
Huntington, WV 25703-1642
Phone (304) 697-1396
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6592630500 | Medicaid | KY | |
| CJ2698 | Other | WV | RR MEDICARE GROUP |
| 7100226540 | Medicaid | KY | |
| 0035275000 | Medicaid | WV |
Other names
- Valley Health Stepptown
Other providers in Kermit, WV
- Kimberly Sue Sturgell
- Whitney Renea Sturgell
- Angel Beth Sumpter
- Therapy Providers Service Organization, LLC
- Three Rivers Medical Clinics Inc
- Tonya Vance
- Kasey Dawn Walker
- Heather Lynn Waller
- Ashley Rena Ward
- Alisha Michelle Williams
All providers in Kermit, WV · Federally Qualified Health Center (FQHC) in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.