NPIMap

Organization Active NPI

Valley Health Systems, Inc

Doing business as Valley Health 10th Street

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
National Provider Identifier
1881054476
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VALLEY HEALTH SYSTEMS, INC
Doing business as
Valley Health 10th Street
Practice address
540 10TH St
Huntington, WV 25701-2217
Phone
(304) 399-3366
Fax
(304) 522-0091
NPI assigned
Feb 25, 2016
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Mary-Beth Brubeck
Title
Vice President of Finance / Cfo
Phone
(304) 525-3334

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X WV

Addresses

Primary practice location

540 10TH St
Huntington, WV 25701-2217

Mailing address

2585 3Rd Ave
Huntington, WV 25703-1642
Phone (304) 697-1396

Other names 1

  • Valley Health 10th Street Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160318000254 WV Part A Provider - Federally Qualified Health Center (FQHC) 9931017969 Practice locations: Huntington, WV
O20160627002459 WV Part B Supplier - Clinic/Group Practice 9931017969 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
Practice locations: Huntington, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881054476. Details of each certification follow.

Federally qualified health center certification: CCN 511092

Legal name
VALLEY HEALTH SYSTEMS, INC
Doing business as
VALLEY HEALTH 10TH STREET
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 1, 2016
Last certification
Mar 1, 2016
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jan 24, 2016 in WV
Enrollment address
540 10TH St
Huntington, WV 25701-2217

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Valley Health Wayne Dental Services91 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

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
Sherry Perry Individual Corporate Director Feb 1, 1994
Christina Walter Individual Corporate Director Apr 25, 2019
Jared Colker Individual Corporate Director Dec 8, 2016
Debra Zuberbuehler Individual Corporate DirectorBoard Member Jan 1, 2025
Paulette Mabry Individual Corporate Director Dec 8, 2016
Bill Bryant Individual Corporate Director Apr 28, 2011
Suzi Brodof Individual Corporate Director Oct 26, 2017
Mathew Weimer Individual Corporate OfficerPresident, Ceo Sep 28, 2024
W-2 Managing Employee Sep 28, 2024
Sherrone Hornbuckle Individual Corporate Director Oct 26, 2017
Mary-Beth Brubeck Individual Corporate OfficerExecutive Vice President / Cfo Jan 1, 2019
W-2 Managing EmployeeExecutive Vice President / Cfo Jan 1, 2019
Kalyn Obiozor Dorey Individual Corporate Director Nov 22, 2022
Greg Agee Individual Corporate DirectorBoard Member Jan 27, 2005
Xavier Staggs Individual Corporate DirectorBoard Member Jan 1, 2025
Benjamin L Howard Individual Corporate Director Jan 1, 2003

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Valley Health Apple GroveApple Grove, WV, CCN 581056 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 16, 1975
Valley Health SCP - Charleston 108Charleston, WV, CCN 581062 Federally qualified health center Operational/Managerial Control Feb 1, 2024

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1881054476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031642",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 10TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012217",
            "telephone_number": "304-399-3366",
            "fax_number": "304-522-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-25",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "BRUBECK",
        "authorized_official_first_name": "MARY-BETH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE / CFO",
        "authorized_official_telephone_number": "304-525-3334"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health 10th Street",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health 10th Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.