NPIMap

Organization Active NPI

Valley Health Systems Inc

Doing business as Valley Health Stepptown

  • Federally Qualified Health Center (FQHC)
  • Kermit, WV
National Provider Identifier
1720054489
Registry record updated Mar 31, 2022
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 Stepptown
Practice address
3 Adena Dr
Kermit, WV 25674-8063
Phone
(304) 393-4090
Fax
(304) 393-4091
NPI assigned
Feb 23, 2006
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Mary-Beth Brubeck
Title
Vice President of Finance / Cfo
Phone
(304) 525-3334

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 19741 WV
Federally Qualified Health Center (FQHC) 261QF0400X WV Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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 names 1

  • Valley Health Stepptown Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720054489. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Apr 1, 1975 in WV
Enrollment address
3 Adena Dr
Kermit, WV 25674-8063
Related CCNs
511803

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

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 Jun 16, 2003
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 Oct 26, 2017
Mary-Beth Brubeck Individual Corporate OfficerExecutive Vice President / Cfo Jan 1, 2019
W-2 Managing EmployeeExecutive Vice President / Cfo Jan 1, 2019
Kalyn Obiozor Dorey Individual Corporate Director 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 Jun 16, 2003

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 2

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": "1648684800000",
    "number": "1720054489",
    "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": "3 ADENA DR",
            "city": "KERMIT",
            "state": "WV",
            "postal_code": "256748063",
            "telephone_number": "304-393-4090",
            "fax_number": "304-393-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "BRUBECK",
        "authorized_official_first_name": "MARY-BETH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE / CFO",
        "authorized_official_telephone_number": "304-525-3334"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "19741",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WV",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Stepptown",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health Stepptown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kermit, WV

Sources for this page

Verify at the official NPI Registry.