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Potomac Valley Hospital of W VA , Inc

Organization Active NPI Critical Access Hospital · Keyser, WV

NPI 1912979873 · NPPES record last updated Oct 12, 2023

Key facts

NPI
1912979873
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
02 (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
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 2

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

Other NPIs with the same Medicare PAC ID 5

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

Member of 1

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

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

Facilities with the same owner 52

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

View all 52

Practitioners 173

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 173

Affiliated clinicians 354

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

View all 354

Medicare Care Compare: Hospital

Listed as
Potomac Valley Hospital CCN 511315
Overall star rating
★☆☆☆☆ 1 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WV

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
Corporation · Non-profit
Incorporated
Jul 1, 1958 in WV
Enrollment address
100 Pin Oak Lane
Keyser, WV 26726-2643
Other Hospital Practice Location

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 Employee
Manager Enterprise Pat Fin Services		 Jun 1, 2021
Okey Silman
Individual 		W-2 Managing Employee
Director-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 Officer
Ceo		 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 Employee
Director-Physicians Practice MGMT		 Apr 3, 2014
Robin Haupt
Individual 		Corporate Director Sep 1, 2017

Medicare enrollment records

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

National Provider Directory

Locations

537 S Mineral St
Keyser, WV 26726
Phone (304) 788-1274

Specialties & licenses

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

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

Other identifiers

IdentifierTypeStateIssuer
3810000637MedicaidWV

Electronic endpoints

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

Other providers in Keyser, WV

All providers in Keyser, WV · Critical Access Hospital in West Virginia

Sources for this page

Verify at the official NPI Registry.