NPIMap

Organization Active NPI

Potomac Valley Hospital of W VA , Inc

  • Critical Access Hospital
  • Keyser, WV
National Provider Identifier
1912979873
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
02 Issued in WV
Legal business name
POTOMAC VALLEY HOSPITAL OF W VA , INC
Practice address
100 Pin Oak LN
Keyser, WV 26726-5908
Phone
(304) 597-3525
Fax
(304) 597-3536
NPI assigned
Feb 6, 2006
Last updated
Oct 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Mr. Harold A McBee Sr.
Title
Owner
Phone
(410) 643-3393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 02 WV Primary

Addresses

Primary practice location

100 Pin Oak LN
Keyser, WV 26726-5908

Mailing address

100 Pin Oak Lane
Keyser, WV 26726-2643
Phone (304) 597-3525

Electronic endpoints 2

TypeEndpointUseAffiliation
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000290 WV Part A Provider - Critical Access Hospital 8123917788 Receives reassigned benefits from 165 practitioners
Practice locations: Keyser, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912979873. Details of each certification follow.

Hospital certification: CCN 511315

Legal name
POTOMAC VALLEY HOSPITAL OF W VA , INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2004
Last certification
Sep 8, 2005
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1958 in WV
Enrollment address
100 Pin Oak Lane
Keyser, WV 26726-2643
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Potomac Valley HospitalCCN 511315 · All quality measures
Overall star rating
1 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jerry E Whisner Individual Corporate Director Sep 1, 2017
Marjorie S Fridkin Individual Corporate Director Sep 21, 2023
Kevin Clark Individual Corporate Director Mar 27, 2018
Deborah Burge Individual W-2 Managing EmployeeManager Enterprise Pat Fin Services Jun 1, 2021
Okey Silman Individual W-2 Managing EmployeeDirector-Revenue Cycle Integration Jul 1, 2019
Dinah Courrier Individual Corporate Director Nov 20, 2019
Lewis Kitzmiller Individual Corporate Director Jul 20, 2022
West Virginia United Health System, Inc Organization, Morgantown, WV Non-profit Operational/Managerial Control Jan 1, 2005
Mark Boucot Individual Corporate OfficerCeo Jan 1, 2018
Harshad S Bokil Individual Corporate Director Sep 21, 2023
Frances L Jones Individual Corporate Director Nov 27, 2018
Sue a Wells Individual W-2 Managing EmployeeDirector-Physicians Practice MGMT Apr 3, 2014
Robin Haupt Individual Corporate Director Sep 1, 2017

Owners & managing parties with NPI records 2

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

Facilities with the same owner 52

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 52

Practitioners & affiliated clinicians

Practitioners 168

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 168

Affiliated clinicians 354

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 354

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1912979873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PIN OAK LANE",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267262643",
            "telephone_number": "304-597-3525",
            "fax_number": "304-597-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PIN OAK LN",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267265908",
            "telephone_number": "304-597-3525",
            "fax_number": "304-597-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC VALLEY HOSPITAL OF W VA , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "MCBEE",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-643-3393",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WV",
            "license": "02",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Parkway",
            "address_2": "Suite 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21044",
            "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": []
}

Other providers in Keyser, WV

Sources for this page

Verify at the official NPI Registry.