Camc Plateau Medical Center, Inc.
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Oak Hill, WV
NPI 1821704347 · NPPES record last updated Jan 27, 2023
Key facts
- NPI
- 1821704347
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- Legal business name
- CAMC PLATEAU MEDICAL CENTER, INC.
- Practice address
- 430 Main St W
Oak Hill, WV 25901-3414 - Phone
- (304) 469-8600
- NPI assigned
- Jan 27, 2023
- Organization subpart
- No
Authorized official
- Name
- Chad Hovis
- Title
- VP of Finance
- Phone
- (304) 388-6251
Owners & managing parties with NPI records 1
-
Glenn Crotty Jr., MD
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 1
Related certifications (CCN) 1
Facilities with the same owner 17
Affiliated clinicians 4
-
Erika Leigh Beckett, M.D.
-
Scott A Keffer, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Hospital certification: CCN 51Z317
- Legal name
- CAMC PLATEAU MEDICAL CENTER, INC.
- Doing business as
- CAMC PLATEAU MEDICAL CENTER
- Organization structure
- Corporation · Proprietary
- Incorporated
- Dec 22, 2022 in WV
- Enrollment address
- 430 Main St W
Oak Hill, WV 25901-3414
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Glenn Crotty |
Corporate Director |
Dec 22, 2022 | |
| W-2 Managing Employee |
Dec 22, 2022 | ||
| David L Ramsey |
Corporate Director |
Dec 22, 2022 | |
| W-2 Managing Employee |
Dec 22, 2022 | ||
| Chad Hovis |
Corporate Director |
Dec 22, 2022 | |
| W-2 Managing Employee |
Dec 22, 2022 | ||
| Vandalia Health Inc |
5% Or Greater Direct Ownership Interest | Dec 22, 2022 | 100% |
| Operational/Managerial Control | Dec 22, 2022 | 100% | |
| Jeffrey D Sandene |
Corporate Director |
Dec 22, 2022 | |
| W-2 Managing Employee |
Dec 22, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230510002026 | WV | Part a Provider - Critical Access Hospital | 4385009877 | Practice locations: Oak Hill, WV |
National Provider Directory
- Tax ID family
- Camc Plateau Medical Center Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | Yes |
Addresses
Primary practice location
430 Main St W
Oak Hill, WV 25901-3414
Mailing address
501 Morris St
Charleston, WV 25301-1326
Other providers in Oak Hill, WV
- Tiffany Cales
- Brianna Callicutt
- Gary Callicutt
- Camc Plateau Medical Center, Inc.
- Camc Plateau Medical Center, Inc.
- Chrisann Camerson
- Beverly Campbell
- Christie Campbell
- Jack Campbell
- Thomas A Campbell
All providers in Oak Hill, WV · Medicare Defined Swing Bed Hospital Unit in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.