Organization Active NPI

Camden-Clark Memorial Hospital Corporation

Doing business as Camden Clark Medical Center

Skilled Nursing Facility
Parkersburg, WV

National Provider Identifier

1841221561

Registry record updated Oct 6, 2023

On this page

Key facts
NPPES NPI Registry
National Provider Directory
NPI Registry JSON
Other providers in Parkersburg, WV
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Skilled Nursing FacilityTaxonomy code 314000000X
License: 102 Issued in WV
Legal business name: CAMDEN-CLARK MEMORIAL HOSPITAL CORPORATION
Doing business as: Camden Clark Medical Center
Practice address: 800 Garfield Avenue
Parkersburg, WV 26101-5378
Phone: (304) 424-2111
Fax: (304) 424-2853
NPI assigned: Jul 5, 2006
Last updated: Oct 6, 2023By the provider in NPPES
Organization subpart: Yes
Parent organization: CAMDEN-CLARK HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Authorized official

Name: Michael A King
Title: Ceo
Phone: (304) 424-2111

Specialties & licenses 1

Specialty (taxonomy)	Code	License	State	Primary
Skilled Nursing Facility	314000000X	102	WV	Primary

Addresses

Primary practice location

800 Garfield Avenue
Parkersburg, WV 26101-5378

Mailing address

Post Office Box 718
800 Garfield Avenue
Parkersburg, WV 26102-0718
Phone (304) 424-2111

Other identifiers 12

Identifier	Type	State	Issuer
333916	Other		GOVERNMENT EMPLOYEES HOSPITAL ASSOCIATION
333916	Other		GOV'T EMP. HOSP. ASSOC.
1252602	Other		OHIO DEPARTMENT OF JOBS AND FAMILY SERVICES
N180	Other		HEALTH PLAN
001741795	Other		BLUE CROSS
124467100	Other		FED COMP
1252602	Medicaid	OH
333916	Other		ALLIANCE/MAMSI INS.
0001155000	Medicaid	WV
039528299	Other		FED COMP/ENERGY EMP OCC ILLNESS
124467100	Other		FEDERAL WORKERS COMP.
333916	Other		ALLIANCE/MAMSI INSURANCE

Other names 1

Camden Clark Medical Center Doing business as

Electronic endpoints 2

Type	Endpoint	Use	Affiliation
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

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1841221561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 718",
            "address_2": "800 GARFIELD AVENUE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261020718",
            "telephone_number": "304-424-2111",
            "fax_number": "304-424-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GARFIELD AVENUE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015378",
            "telephone_number": "304-424-2111",
            "fax_number": "304-424-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMDEN-CLARK MEMORIAL HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMDEN-CLARK HEALTH SERVICES",
        "enumeration_date": "2006-07-05",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-424-2111"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WV",
            "license": "102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOVERNMENT EMPLOYEES HOSPITAL ASSOCIATION",
            "identifier": "333916",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOV'T EMP. HOSP. ASSOC.",
            "identifier": "333916",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO DEPARTMENT OF JOBS AND FAMILY SERVICES",
            "identifier": "1252602",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN",
            "identifier": "N180",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "001741795",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED COMP",
            "identifier": "124467100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1252602",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE/MAMSI INS.",
            "identifier": "333916",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001155000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED COMP/ENERGY EMP OCC ILLNESS",
            "identifier": "039528299",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKERS COMP.",
            "identifier": "124467100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE/MAMSI INSURANCE",
            "identifier": "333916",
            "state": null
        }
    ],
    "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 Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "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": "Camden Clark Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Camden Clark Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parkersburg, WV

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.