NPIMap

Organization Active NPI

Shenandoah Valley Family Health Center

Doing business as Shenandoah Valley Medical System,Inc.

  • Federally Qualified Health Center (FQHC)
  • Inwood, WV
National Provider Identifier
1881893550
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SHENANDOAH VALLEY FAMILY HEALTH CENTER
Doing business as
Shenandoah Valley Medical System,Inc.
Practice address
102 Hovater Drive
Inwood, WV 25428
Phone
(304) 263-4999
Fax
(304) 263-0984
NPI assigned
Jul 13, 2007
Last updated
May 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
David Fant
Title
Ceo
Phone
(304) 263-4999

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

102 Hovater Drive
Inwood, WV 25428

Mailing address

PO Box 1146
Martinsburg, WV 25402-1146
Phone (304) 263-4999

Other identifiers 1

IdentifierTypeStateIssuer
0035217007MedicaidWV

Other names 1

  • Shenandoah Valley Medical System,Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shenandoah Community Health11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

102 Hovatter Dr
Inwood, WV 25428
Phone (304) 229-0300

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1881893550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1146",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254021146",
            "telephone_number": "304-263-4999",
            "fax_number": "304-263-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HOVATER DRIVE",
            "city": "INWOOD",
            "state": "WV",
            "postal_code": "25428",
            "telephone_number": "304-263-4999",
            "fax_number": "304-263-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH VALLEY FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "FANT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-263-4999"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035217007",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shenandoah Valley Medical System,Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inwood, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.