Edgewood Summit Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EDGEWOOD SUMMIT INC

Practice address

300 Baker LN
Charleston, WV 25302-2900

Phone

(304) 346-2323

Fax

(304) 346-2352

NPI assigned

May 13, 2013

Last updated

Feb 13, 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

Mrs. Diane Gouhin

Title

Executive Director

Phone

(304) 346-2323

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750727145. Details of each certification follow.

• CCN 515193 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 515193

Legal name

EDGEWOOD SUMMIT INC

Doing business as

THE ARTHUR B HODGES CENTER AT EDGEWOOD SUMMIT

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

Apr 25, 2014

Last certification

Aug 23, 2023

Beds

20

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Jul 26, 1990 in WV

Enrollment address

300 Baker LN
Charleston, WV 25302-2900

Nursing home name

ARTHUR B HODGES CENTER, THE

Listed as

Arthur B Hodges Center, theCCN 515193 · All quality measures

Overall star rating

4 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

1 of 5

Type

Medicare

Ownership

Non profit - Corporation

Certified

Apr 25, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

2018.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 39

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

Owners & managing parties with NPI records 1

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

• Roy Thomas Bowden III, DO

  • Internal Medicine Physician
  • Charleston, WV
  • NPI 1174594642

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Joshua W Kidd

  • Skilled Nursing Facility
  • Charleston, WV
  • NPI 1578350138
  NPD
• Todd Harley Goldberg, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Wilmington, NC
  • NPI 1639122492
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Roy Thomas Bowden III, DO

  • Internal Medicine Physician
  • Charleston, WV
  • NPI 1174594642

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1750727145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BAKER LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BAKER LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022900",
            "telephone_number": "304-346-2323",
            "fax_number": "304-346-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD SUMMIT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "GOUHIN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-346-2323",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Eddy
• Elizabeth Maree Eddy
• Jennifer Eddy
• David E Ede, MD
• Angela Edgerton
• Mona Edmonds
• Edmundo E. Figueroa, MD Inc
• Denise Edunueko
• Edward H. Tiley, III, M.D, Inc.
• Edward J. Grey, M.D.

• Skilled Nursing Facility in Charleston, WV
• Providers in Charleston, WV by specialty
• Skilled Nursing Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.