NPIMap

Organization Active NPI

Rainelle Medical Center, Inc.

Doing business as Alderson Medical Center

  • Federally Qualified Health Center (FQHC)
  • Alderson, WV
National Provider Identifier
1740589746
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RAINELLE MEDICAL CENTER, INC.
Doing business as
Alderson Medical Center
Practice address
101 Railroad Avenue
Alderson, WV 24910-0740
Phone
(304) 438-6188
Fax
(304) 438-4037
NPI assigned
Mar 17, 2011
Last updated
Mar 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Mrs. Debra J Bennett
Title
Credentialing Specialist
Phone
(304) 438-6188

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

101 Railroad Avenue
Alderson, WV 24910-0740

Mailing address

645 Kanawha Ave
Rainelle, WV 25962-1013
Phone (304) 438-6188

Other names 1

  • Alderson Medical Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040310000112 WV Part B Supplier - Public Health/Welfare Agency 7416861810 Receives reassigned benefits from 73 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alderson, WV; Meadow Bridge, WV; Rainelle, WV
O20120328000326 WV Part A Provider - Federally Qualified Health Center (FQHC) 7416861810 Practice locations: Alderson, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740589746. Details of each certification follow.

Federally qualified health center certification: CCN 511977

Legal name
RAINELLE MEDICAL CENTER INC
Doing business as
ALDERSON MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 28, 2012
Last certification
Mar 28, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 13, 1988 in WV
Enrollment address
101 Railroad Avenue
Alderson, WV 24910-0740

Other NPIs with the same Medicare PAC ID 15

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

View all 15

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

205 Medical Center Dr
Rainelle, WV 25962
Phone (304) 438-1922

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
Davida Farley Individual Corporate Director Jan 1, 2003
Stephen Baldwin Individual Corporate OfficerBoard Member Jan 1, 2022
Kristi Atha-Rader Individual W-2 Managing Employee Jun 30, 2008
Gary G Veronneau Individual Corporate Director Jan 1, 2006
Elizabeth Campbell Individual Corporate OfficerBoard Member Jan 1, 2022
Kimberly Howard Individual Corporate Director Jan 1, 2006
Ron Fleshman Individual Corporate Director Jan 1, 2006
Barry Crist Individual Corporate OfficerBoard Member Jan 1, 2022
Debra J Bennett Individual Corporate Officer Jan 4, 1999
Nina Blankenship Individual Corporate OfficerBoard Member Jan 1, 2022
Christopher Clay Individual Contracted Managing Employee Dec 15, 2008
Henry Bivens Individual Corporate OfficerBoard Member Jan 1, 2022
Jessie Boone Individual Corporate OfficerBoard Member Jan 1, 2019
Frank Mullins Individual Corporate Director Jan 1, 2001

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 4

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

FacilityTypeRoleSince
Midland Trail Health CenterHico, WV, CCN 511152 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2018
Lewisburg Health CenterLewisburg, WV, CCN 511158 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2018
RMC Greenbrier Nephrology AlleghanyCovington, VA, CCN 491974 Federally qualified health center Operational/Managerial Control Jul 1, 2020
Rupert Health CenterRupert, WV, CCN 581046 Federally qualified health center Operational/Managerial Control (100%) Jun 26, 2024

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1740589746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 KANAWHA AVE",
            "city": "RAINELLE",
            "state": "WV",
            "postal_code": "259621013",
            "telephone_number": "304-438-6188",
            "fax_number": "304-438-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RAILROAD AVENUE",
            "city": "ALDERSON",
            "state": "WV",
            "postal_code": "249100740",
            "telephone_number": "304-438-6188",
            "fax_number": "304-438-4037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINELLE MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "304-438-6188",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alderson Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alderson Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alderson, WV

Sources for this page

Verify at the official NPI Registry.