NPIMap

Organization Active NPI

Valley Health Systems Inc

Doing business as Valley Health Highlawn

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
National Provider Identifier
1902962368
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 Highlawn
Practice address
2585 3Rd Ave
Huntington, WV 25703
Phone
(304) 781-5138
Fax
(304) 781-5139
NPI assigned
Dec 29, 2006
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
Mr. Mary-Beth Brubeck
Title
Vice President of Finance / Cfo
Phone
(304) 525-3334

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Nurse Practitioner 363L00000X WV
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

2585 3Rd Ave
Huntington, WV 25703

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
CJ2698OtherWVRR MEDICARE GROUP
2774921MedicaidOH
3810009599MedicaidWV

Other names 1

  • Valley Health Highlawn Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040325000411 WV Part B Supplier - Public Health/Welfare Agency 9931017969 Receives reassigned benefits from 154 practitioners
15 other NPIs on this enrollment
Practice locations: Huntington, WV; Wayne, WV; Ona, WV; Kermit, WV; Hurricane, WV; Harts, WV; Fort Gay, WV; Cedar Grove, WV
O20040325000570 WV Part B Supplier - Clinic/Group Practice 9931017969 Receives reassigned benefits from 41 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntington, WV; Hurricane, WV; Harts, WV; Fort Gay, WV
O20070509000734 WV Part A Provider - Federally Qualified Health Center (FQHC) 9931017969 Practice locations: Huntington, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902962368. Details of each certification follow.

Federally qualified health center certification: CCN 511926

Legal name
VALLEY HEALTH SYSTEMS, INC
Doing business as
VALLEY HEALTH HIGHLAWN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 21, 2007
Last certification
May 21, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 28, 1975 in WV
Enrollment address
2585 3Rd Ave
Huntington, WV 25703-1642

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory

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 DirectorBoard Member Jan 1, 1994
Christina Walter Individual Corporate DirectorBoard Member Apr 25, 2019
Jared Colker Individual Corporate DirectorBoard Member Dec 8, 2016
Debra Zuberbuehler Individual Corporate DirectorBoard Member Jan 1, 2025
Paulette Mabry Individual Corporate DirectorBoard Member Dec 8, 2016
Bill Bryant Individual Corporate DirectorBoard Member Jan 1, 2011
Suzi Brodof Individual Corporate DirectorBoard Member Oct 26, 2017
Mathew Weimer Individual Corporate OfficerPresident, Ceo Sep 28, 2024
W-2 Managing Employee Sep 28, 2024
Sherrone Hornbuckle Individual Corporate DirectorBoard Member Dec 8, 2016
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 1, 2006
Xavier Staggs Individual Corporate DirectorBoard Member Jan 1, 2025
Benjamin L Howard Individual Corporate DirectorBoard Member 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 161

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 161

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1902962368",
    "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": "2585 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25703",
            "telephone_number": "304-781-5138",
            "fax_number": "304-781-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CJ2698",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2774921",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009599",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Highlawn",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health Highlawn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.