Community Health Systems, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Glen Daniel, WV
NPI 1922204643 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1922204643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COMMUNITY HEALTH SYSTEMS, INC.
- Practice address
- 7127 Harper Road
Glen Daniel, WV 25844 - Phone
- (304) 934-4000
- Fax
- (304) 934-4005
- NPI assigned
- Jun 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Charles Hunt
- Title
- Executive Director
- Phone
- (304) 252-8374
Other NPIs on the same Medicare enrollment 10
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D1070897 | Access Health Glen Daniel | Certificate of waiver | Jul 11, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
Federally qualified health center certification: CCN 511829
- Legal name
- COMMUNITY HEALTH SYSTEMS INC
- Doing business as
- ACCESS HEALTH
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 1, 1991
- Last certification
- Oct 1, 1991
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 20, 1967 in WV
- Enrollment address
- 7031 Harper Rd
Glen Daniel, WV 25844-9480
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Carl Bowman |
Corporate Director | Jun 19, 2007 | |
| Chris Davis |
Corporate Director | Jun 19, 2007 | |
| Carolyn Dilorenzo |
Corporate Director | Jun 19, 2007 | |
| Gregory Hazuka |
Corporate Director | Jun 19, 2007 | |
| Charles Hunt |
Corporate Officer |
Apr 17, 2000 | |
| W-2 Managing Employee | Jun 19, 2007 |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Access Health |
Federally qualified health center | Operational/Managerial Control | Aug 25, 2017 |
| Community Health Systems Inc |
Federally qualified health center | Operational/Managerial Control | Oct 1, 2018 |
| Accesshealth |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2019 |
| Accesshealth Daniels Elementary School |
Federally qualified health center | Operational/Managerial Control | Apr 17, 2000 |
| Community Health Systems Inc |
Federally qualified health center | Operational/Managerial Control | Apr 17, 2000 |
| Accesshealth Stratton Elementary |
Federally qualified health center | Operational/Managerial Control | Oct 31, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040311000504 | WV | Part B Supplier - Public Health/Welfare Agency | 6608785795 |
Receives reassigned benefits from 106 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Beckley, WV |
| O20070703000683 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 6608785795 | Practice locations: Glen Daniel, WV |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
7127 Harper Road
Glen Daniel, WV 25844
Mailing address
7127 Harper Road
Glen Daniel, WV 25844
Phone (304) 934-4000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4492234 | Other | AETNA |
Other names
- Access Health
Other providers in Glen Daniel, WV
- Misty Brown
- Tasha Marie Chaver-Fajarido
- Rebecca Clark
- Community Health Systems Inc
- Community Health Systems Inc
- Community Health Sytems, Inc
- Linda Cook
- Country Roads Pharmacy Inc
- Dr Ralph E Simms Inc
- Courtney Elizabeth Epling
All providers in Glen Daniel, WV · Federally Qualified Health Center (FQHC) 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 Aug 22, 2020. 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.