NPIMap

Organization Active NPI

Herbert J. Thomas Memorial Hospital Association

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Charleston, WV
National Provider Identifier
1790028744
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
109 Issued in WV
Legal business name
HERBERT J. THOMAS MEMORIAL HOSPITAL ASSOCIATION
Practice address
4825 Maccorkle Ave SW
Suite D
South Charleston, WV 25309-1365
Phone
(304) 766-4560
Fax
(304) 766-4599
NPI assigned
Mar 28, 2013
Organization subpart
Yes
Parent organization
THOMAS HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Authorized official

Name
Mr. Patrick L Fields, MPH
Title
Administrative Director of BHS
Phone
(304) 766-3441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 109 WV Primary

Addresses

Primary practice location

4825 Maccorkle Ave SW
Suite D
South Charleston, WV 25309-1365

Mailing address

4825 Maccorkle Ave SW
Suite D
South Charleston, WV 25309-1365
Phone (304) 766-4560

Other identifiers 2

IdentifierTypeStateIssuer
50090MedicaidWV
0001391000MedicaidWV

Other names 1

  • Southway Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rodney Dean MD PLLC19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1790028744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 MACCORKLE AVE SW",
            "address_2": "SUITE D",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091365",
            "telephone_number": "304-766-4560",
            "fax_number": "304-766-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 MACCORKLE AVE SW",
            "address_2": "SUITE D",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091365",
            "telephone_number": "304-766-4560",
            "fax_number": "304-766-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERBERT J. THOMAS MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THOMAS HEALTH SYSTEM, INC.",
        "enumeration_date": "2013-03-28",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR OF BHS",
        "authorized_official_telephone_number": "304-766-3441",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WV",
            "license": "109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50090",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001391000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.