NPIMap

Organization Active NPI

St. Joseph'S Hospital of Buckhannon, Inc.

  • Rural Health Clinic/Center
  • Buckhannon, WV
National Provider Identifier
1780223370
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC.
Practice address
94 W Main St
Buckhannon, WV 26201-2284
Phone
(304) 473-2202
NPI assigned
Dec 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Forest Hannah
Title
Cfo
Phone
(304) 872-2891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

94 W Main St
Buckhannon, WV 26201-2284

Mailing address

1 Amalia Dr
Buckhannon, WV 26201-2239

Other names 1

  • St Josephs Clinic, A Rural Health Clinic Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com Other
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200220002147 WV Part A Provider - Rural Health Clinic 6709828163 Practice locations: Buckhannon, WV

Rural health clinic certification: CCN 513424

Legal name
ST JOSEPH'S HOSPITAL OF BUCKHANNON INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 29, 2020
Last certification
Jul 29, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 17, 1989 in WV
Enrollment address
94 W Main St
Buckhannon, WV 26201
Related CCNs
511321

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

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2177614St Joseph'S Hospital - Rural Health Clinic94 West Main Street, Buckhannon, WV 26201Certificate of waiverJan 14, 2028

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.

Locations

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

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
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
W-2 Managing EmployeeCfo Mar 1, 2026
John K Bohman Individual Corporate DirectorBoard Member Dec 1, 2024
Brandon Tenney Individual Corporate DirectorBoard Member Mar 1, 2026
Danielle C Ware Individual Corporate DirectorBoard Member Mar 1, 2026
West Virginia United Health System, Inc Organization, Morgantown, WV Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 2024 100%
Keith Buchanan Individual Corporate DirectorBoard Member Dec 1, 2024
John C Forester Individual Corporate OfficerPresident Mar 1, 2026
W-2 Managing EmployeePresident Mar 1, 2026
Donald B Nestor Individual Corporate DirectorBoard Member Nov 1, 2017
Danuta Pryzbylek Individual Corporate DirectorBoard Member Dec 1, 2024
Donovan Hanifan Individual Corporate DirectorBoard Member Jul 1, 2017
Bartley Brown Individual Corporate DirectorBoard Member Jan 1, 2018
Kelley Tierney Individual Corporate DirectorBoard Member Dec 1, 2024

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": "1577664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1780223370",
    "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": "262012239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 W MAIN ST",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012284",
            "telephone_number": "304-473-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-30",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "HANNAH",
        "authorized_official_first_name": "FOREST",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "304-872-2891"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Parkway",
            "address_2": "Suite 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St Josephs Clinic, A Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buckhannon, WV

Sources for this page

Verify at the official NPI Registry.