NPIMap

Organization Active NPI

Hospital Development Co

  • Rural Health Clinic/Center
  • Spencer, WV
National Provider Identifier
1790745172
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
74 Issued in WV
Legal business name
HOSPITAL DEVELOPMENT CO
Practice address
200 Hospital Dr
Spencer, WV 25276-1050
Phone
(304) 927-6819
Fax
(304) 927-6837
NPI assigned
Mar 28, 2006
Organization subpart
Yes
Parent organization
ROANE GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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

Authorized official

Name
Doug Bentz
Title
Ceo
Phone
(304) 927-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 74 WV Primary

Addresses

Primary practice location

200 Hospital Dr
Spencer, WV 25276-1050

Mailing address

200 Hospital Dr
Spencer, WV 25276-1050
Phone (304) 927-6819

Other identifiers 1

IdentifierTypeStateIssuer
0123058001MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040710000241 WV Part A Provider - Rural Health Clinic 4183527476 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Walton, WV
O20180412000319 WV Part A Provider - Rural Health Clinic 4183527476 Practice locations: Spencer, WV

Rural health clinic certification: CCN 513417

Legal name
HOSPITAL DEVELOPMENT CO.
Doing business as
ROANE GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 27, 2013
Last certification
Jul 10, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 11, 1996 in WV
Enrollment address
7313 Charleston Rd
Walton, WV 25286-9613
Related CCNs
511306

Rural health clinic certification: CCN 513990

Legal name
HOSPITAL DEVELOPMENT CO.
Doing business as
ROANE GENERAL MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 11, 1996
Last certification
Jan 7, 2022
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 11, 1996 in WV
Enrollment address
200 Hospital Dr
Spencer, WV 25276-1050
Related CCNs
511306

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 2

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

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
51D0916268Roane General Medical Clinic200 Hospital Drive, Spencer, WV 25276Certificate of waiverJun 17, 2028

National Provider Directory

National Provider Directory
Part of
Hospital Development Co

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Kevin Gaughan Individual Other Sep 26, 2016
Corporate DirectorMember, Board of Directors Oct 1, 2016
Floyd Bowlby Individual Other Oct 1, 2020
Emily Westfall Individual Other Sep 28, 2020
Corporate DirectorMember, Board of Directors Sep 28, 2020
John Varda Individual Corporate Director May 27, 1999
Corporate DirectorTreasurer, Board of Directors May 27, 1999
Amy Downey Individual W-2 Managing Employee Jan 1, 2025
Operational/Managerial Control Jan 1, 2025
Corporate Director Feb 4, 2019
W-2 Managing EmployeeChief Financial Officer Feb 4, 2019
Grant Stephen Parkins Individual W-2 Managing EmployeeMedical Director Oct 1, 2014
Hospital Development Co. Organization, Spencer, WV Non-profit 5% Or Greater Direct Ownership Interest Jun 3, 2013 100%
Operational/Managerial Control Jun 3, 2013 100%
Douglas Bentz Individual Corporate DirectorEx Officio: Ceo Oct 4, 2000
W-2 Managing EmployeeCeo Oct 4, 2000
Corporate DirectorExofficio Member, Board of Director Oct 9, 2000
W-2 Managing EmployeeChief Financial Officer Oct 9, 2000
John Taylor Individual Corporate Director Aug 20, 2004
Corporate DirectorMember, Board of Directors Mar 28, 2002
Robert E. Zdanek Individual Corporate Director Jan 26, 2004
Corporate DirectorMember, Board of Directors Jan 26, 2004
Jack Garrett Individual Corporate Director Jun 5, 1995
Corporate DirectorPresident Jun 5, 1995
Gloria Atkinson Individual Corporate Director Sep 24, 2007
Corporate DirectorSecretary, Board of Directors Sep 27, 2007
William Downey Individual Corporate Director May 24, 2001
Corporate DirectorVice President May 24, 2001
Paul Hughes Individual Corporate Director May 28, 1998
Corporate DirectorMember, Board of Directors May 28, 1998
Christine Hedges Individual Corporate DirectorMember, Board of Directors Feb 28, 2011
Scott P Duffy Individual Corporate DirectorExofficio Member, Board of Director Jan 1, 2020
W-2 Managing EmployeeMedical Director Sep 12, 2018

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Roane General HospitalSpencer, WV, CCN 515099 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 27, 1970
Jan 27, 1970
Roane General HospitalWalton, WV, CCN 513417 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 3, 2013
Jun 3, 2013
Hospital Development Co.Spencer, WV, CCN 513408 Rural health clinic Operational/Managerial Control Apr 20, 2004
Southern Roane Medical ClinicLeft Hand, WV, CCN 513409 Rural health clinic Operational/Managerial Control Sep 25, 2005
Arnoldsburg Medical ClinicArnoldsburg, WV, CCN 513436 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023

Owned or controlled facilities with NPI records 5

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

Practitioners & affiliated clinicians

Practitioners 73

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

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516060800000",
    "number": "1790745172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761050",
            "telephone_number": "304-927-6819",
            "fax_number": "304-927-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761050",
            "telephone_number": "304-927-6819",
            "fax_number": "304-927-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL DEVELOPMENT CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROANE GENERAL HOSPITAL",
        "enumeration_date": "2006-03-28",
        "last_updated": "2018-01-16",
        "status": "A",
        "authorized_official_last_name": "BENTZ",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-927-6200"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WV",
            "license": "74",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0123058001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, WV

Sources for this page

Verify at the official NPI Registry.