NPIMap

Organization Active NPI

St. Joseph'S Hospital of Buckhannon, Inc.

  • Skilled Nursing Facility
  • Buckhannon, WV
National Provider Identifier
1720183197
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
87 Issued in WV
Legal business name
ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC.
Practice address
1 Amalia Dr
Buckhannon, WV 26201-2276
Phone
(304) 473-2000
Fax
(304) 473-2180
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Authorized official

Name
Mr. Ivar H. Gjolberg Jr.
Title
Administrator
Phone
(304) 473-2118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 87 WV Primary

Addresses

Primary practice location

1 Amalia Dr
Buckhannon, WV 26201-2276

Mailing address

1 Amalia Dr
Buckhannon, WV 26201-2276
Phone (304) 473-2000

Other identifiers 1

IdentifierTypeStateIssuer
0001139003MedicaidWV

Other names 1

  • St. Joseph's Hospital Nursing Care Facility Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100129000261 WV Part A Provider - Skilled Nursing Facility 6709828163 Practice locations: Buckhannon, WV

Skilled nursing facility certification: CCN 515051

Legal name
ST JOSEPH'S HOSPITAL OF BUCKHANNON INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Oct 8, 1974
Last certification
Mar 20, 2025
Beds
16
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 17, 1989 in WV
Enrollment address
1 Amalia Drive
Buckhannon, WV 26201-2239
Nursing home name
ST. JOSEPH'S HOSPITAL
Affiliated entity
WVU MEDICINE

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
St. Joseph'S HospitalCCN 515051
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 8, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
1615.9 residents per day on average
Chain
Wvu Medicine7 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
St Josephs Hospital of Buck7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
David F Hess Individual Corporate DirectorBoard Member Mar 1, 2026
Burton L Abel Individual Corporate DirectorBoard Member Mar 1, 2026
Forest Hannah Individual Corporate OfficerCfo Mar 1, 2026
Operational/Managerial Control Mar 1, 2026
John K Bohman Individual Corporate DirectorBoard Member Dec 8, 2025
Brandon Tenney Individual Corporate DirectorBoard Member Dec 8, 2025
Danielle C Ware Individual Corporate DirectorBoard Member Mar 1, 2026
West Virginia United Health System, Inc Organization, Morgantown, WV Corporation, Chain home office 5% Or Greater Direct Ownership Interest Sep 1, 2022
Keith Buchanan Individual Corporate DirectorBoard Member Dec 8, 2025
Nia Leichliter Individual Corporate OfficerAdministrator Dec 8, 2025
Operational/Managerial Control Dec 18, 2025
Adp of the SNF Dec 18, 2025
John C Forester Individual Corporate OfficerPresident Mar 1, 2026
Operational/Managerial Control Mar 1, 2026
Donald B Nestor Individual Corporate DirectorBoard Member Jan 1, 2017
Danuta Pryzbylek Individual Corporate DirectorBoard Member Dec 8, 2025
Donovan Hanifan Individual Corporate DirectorBoard Member Jul 26, 2017
Bartley Brown Individual Corporate DirectorSnu Medical Director Jan 1, 2016
Adp of the SNF Dec 18, 2025
Kelley Tierney Individual Corporate DirectorBoard Member Dec 8, 2025

Owners & managing parties with NPI records 4

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

Facilities with the same owner 52

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

View all 52

Practitioners & affiliated clinicians

Practitioners 98

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 98

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1720183197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AMALIA DR",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012276",
            "telephone_number": "304-473-2000",
            "fax_number": "304-473-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AMALIA DR",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012276",
            "telephone_number": "304-473-2000",
            "fax_number": "304-473-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "GJOLBERG",
        "authorized_official_first_name": "IVAR",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "304-473-2118",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WV",
            "license": "87",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001139003",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph's Hospital Nursing Care Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Buckhannon, WV

Sources for this page

Verify at the official NPI Registry.