Jefferson Memorial Hospital
Organization Active NPI Critical Access Hospital · Ranson, WV
NPI 1891722377 · NPPES record last updated Oct 12, 2023
Key facts
- NPI
- 1891722377
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 103 (WV)
- Legal business name
- JEFFERSON MEMORIAL HOSPITAL
- Practice address
- 300 S. Preston Street
Ranson, WV 25438-1631 - Phone
- (304) 728-1600
- Fax
- (304) 725-9492
- NPI assigned
- Jun 28, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- WEST VIRGINIA UNIVERSITY HOSPITALS EAST INC
Authorized official
- Name
- Kathleen R Quinones
- Title
- Interim VP Finance
- Phone
- (304) 260-1443
Owners & managing parties with NPI records 5
-
Dawn Jones, M.D.
-
Michael B Edmond, M.D.
-
Marney B Treese, MD
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 1
Related certifications (CCN) 1
Facilities with the same owner 52
Practitioners 161
-
John Casto, MD
-
David Benjamin Deuell, D.O.
-
Charles Keeling, CRNA
-
John Wyatt Miles, D.O.
-
Joseph Anders Mills, PA-C
-
Gaurav Sahay, MD
-
Rachel I Sigel Domenico, FNP-BC
-
David Skibbie, MD
-
Lindsey Morgan Turner, PA-C
-
Imad Ahmado, MD
-
Safdar Ali Akbar, MD
-
Runa Bhattacharya, M.D.
-
Austin Mitchell Grant, PA-C
-
Benjamin Hartland, CRNA
-
Michael D Hinson, FNP-BC
-
Praveen Karunanidhi, CRNA
-
Bradley Kretzer, CRNA
-
Thomas John Luckey, M.D.
Affiliated clinicians 337
-
Michelle Marie Abe, D.O.
-
Quratul Ain, MD
-
Molly Anna Anaya, NP-C
-
Michael Ang-Rabanes, M.D.
-
Sarika Bagree, MD
-
Lori Baker, F-CNP
-
David A Baltierra, M.D.
-
Babak Barmar, MD
-
Breona C Barr, MD
-
Amanda Barton, APRN
-
Brittany Ann Beard, FNP-C
-
Martina E Best, NP
-
John W Buschman, DO
-
John Casto, MD
-
Angela D Cherry, M.D.
Medicare Care Compare: Hospital
- Listed as
- Jefferson Medical Center
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
Hospital certification: CCN 511319
- Legal name
- JEFFERSON MEMORIAL HOSPITAL
- Doing business as
- JEFFERSON MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Dec 15, 2005
- Last certification
- Jan 31, 2018
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 26, 1912 in WV
- Enrollment address
- 300 S Preston St
Ranson, WV 25438-1631
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Brian Romine |
Corporate Director | Jan 1, 2017 | |
| Albert Wright |
Corporate Director | Feb 1, 2022 | |
| Susan Snowden |
Corporate Director | Feb 4, 2019 | |
| Dean Thomas |
W-2 Managing Employee |
Jan 1, 2021 | |
| Chiquita Howard-Bostic |
Corporate Director | Aug 1, 2015 | |
| Deborah Burge |
W-2 Managing Employee | Jun 1, 2021 | |
| Alice Frazier |
Corporate Director | Feb 4, 2019 | |
| West Virginia University Hospitals East Inc |
Operational/Managerial Control | Jan 1, 2005 | |
| James Rogers |
Corporate Director | Apr 2, 2018 | |
| Dawn R Jones |
Corporate Director | May 26, 2015 | |
| Jackee Long |
Corporate Director | Jan 1, 2012 | |
| Grover Zach Kerns |
W-2 Managing Employee |
Jan 25, 2019 | |
| West Virginia United Health System, Inc |
Operational/Managerial Control | Jan 1, 2005 | |
| Michael S Londner |
Corporate Director | Jan 1, 2021 | |
| Marney B Treese |
Corporate Director | Feb 4, 2019 | |
| Douglas Scott Roach |
Corporate Officer |
Jan 1, 2011 | |
| Henry Kayes |
Corporate Director |
Jan 1, 2017 | |
| Emma Morton-Eggleston |
Corporate Director | Jan 1, 2017 | |
| Michael Edmond |
Corporate Director | Jan 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040116000736 | WV | Part B Supplier - Clinic/Group Practice | 0446151989 |
Receives reassigned benefits from 116 practitioners 2 other NPIs on this enrollment Practice locations: Ranson, WV |
| O20230202001687 | WV | Part a Provider - Critical Access Hospital | 0446151989 |
Receives reassigned benefits from 115 practitioners 3 other NPIs on this enrollment Practice locations: Ranson, WV |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 103 | WV | Yes |
Addresses
Primary practice location
300 S. Preston Street
Ranson, WV 25438-1631
Mailing address
PO Box 1170
Morgantown, WV 26507-1170
Phone (304) 598-6795
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810004211 | Medicaid | WV | |
| 005100682 | Medicaid | VA | |
| 000304490 | Other | WV | BLUE CROSS BLUE SHIELD |
| 005805000 | Medicaid | MD |
Other names
- Jefferson Medical Center
Electronic endpoints
| 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 |
Other providers in Ranson, WV
- Jefferson Med-Peds Inc
- Jefferson Memorial Hospital
- Jefferson Memorial Hospital
- Jefferson Memorial Hospital
- Jefferson Memorial Hospital
- Jefferson Memorial Hospital
- Jefferson Pharmacy Inc
- Jefferson Pharmacy Inc LTC
- Jefferson Primary Care
- JMH Emergency Physicians
All providers in Ranson, WV · Critical Access Hospital 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 Oct 12, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.