Community Health Systems Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COMMUNITY HEALTH SYSTEMS INC.

Doing business as

Beckley Statton School-Based Clinic

Practice address

401 Grey Flats Rd
Beckley, WV 25801-5876

Phone

(304) 461-3304

NPI assigned

Sep 13, 2012

Last updated

Apr 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles Hunt

Title

Ceo

Phone

(304) 252-8324

Specialties & licenses 1

Addresses

Other names 1

• Beckley Statton School-Based Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750631099. Details of each certification follow.

• CCN 511052 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 511052

Legal name

COMMUNITY HEALTH SYSTEMS INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 12, 2014

Last certification

Dec 12, 2014

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jun 20, 1967 in WV

Enrollment address

401 Grey Flats Rd
Beckley, WV 25801-5876

Locations

All disclosed owners & managing parties 1

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

All facility ownership & control disclosures 6

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

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1750631099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR.",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "25801",
            "telephone_number": "304-252-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 GREY FLATS RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258015876",
            "telephone_number": "304-461-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH SYSTEMS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-252-8324",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beckley Statton School-Based Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Federally Qualified Health Center (FQHC) in Beckley, WV
• Providers in Beckley, WV by specialty
• Federally Qualified Health Center (FQHC) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.