NPIMap

Organization Active NPI

Shenandoah Memorial Hospital Inc.

  • Rural Health Clinic/Center
  • New Market, VA
National Provider Identifier
1740711472
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SHENANDOAH MEMORIAL HOSPITAL INC.
Practice address
9166 N Congress St
New Market, VA 22844-9422
Phone
(540) 459-1340
Fax
(540) 459-1349
NPI assigned
Mar 24, 2017
Last updated
Jun 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Authorized official

Name
Renee Y Baker
Title
Manger, Insurance Credentialing
Phone
(540) 536-0231

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X VA
Cardiovascular Disease Physician 207RC0000X VA
Neurological Surgery Physician 207T00000X VA
Obstetrics & Gynecology Physician 207V00000X VA
Orthopaedic Surgery Physician 207X00000X VA
Urology Physician 208800000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

9166 N Congress St
New Market, VA 22844-9422

Mailing address

9166 N Congress St
New Market, VA 22844-9422
Phone (540) 459-1340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115001156 VA Part B Supplier - Clinic/Group Practice 2466360375 Receives reassigned benefits from 455 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Strasburg, VA; Woodstock, VA; New Market, VA; Mount Jackson, VA; Luray, VA
O20170830002498 VA Part A Provider - Rural Health Clinic 2466360375 Practice locations: New Market, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740711472. Details of each certification follow.

Rural health clinic certification: CCN 493424

Legal name
SHENANDOAH MEMORIAL HOSPITAL, INC.
Doing business as
VALLEY HEALTH SHENANDOAH MEMORIAL HOSPITAL MULTISPECIALTY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 27, 2017
Last certification
Aug 29, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 29, 1946 in VA
Enrollment address
9166 N Congress St
New Market, VA 22844-9422
Related CCNs
491305

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Shenandoah Memorial Hospital, Inc. Organization, Woodstock, VA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2017 100%
Jill Chambers Individual W-2 Managing Employee Sep 1, 2017
Thomas Scott Kluge Individual Corporate Officer Jan 21, 2021

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Valley Health Shenandoah Memorial Hospital PediatricsWoodstock, VA, CCN 493426 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Shenandoah Memorial Hospital, Inc.Woodstock, VA, CCN 493427 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Valley Health Primary Care StrasburgStrasburg, VA, CCN 493435 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 141

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 141

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1740711472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9166 N CONGRESS ST",
            "city": "NEW MARKET",
            "state": "VA",
            "postal_code": "228449422",
            "telephone_number": "540-459-1340",
            "fax_number": "540-459-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9166 N CONGRESS ST",
            "city": "NEW MARKET",
            "state": "VA",
            "postal_code": "228449422",
            "telephone_number": "540-459-1340",
            "fax_number": "540-459-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH MEMORIAL HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-24",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "MANGER, INSURANCE CREDENTIALING",
        "authorized_official_telephone_number": "540-536-0231"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Market, VA

Sources for this page

Verify at the official NPI Registry.