NPIMap

Organization Active NPI

E. a. Hawse Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Romney, WV
National Provider Identifier
1932868577
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
E. A. HAWSE HEALTH CENTER, INC.
Practice address
301 E Main St
Romney, WV 26757-1828
Phone
(304) 897-5915
Fax
(304) 897-6216
NPI assigned
Dec 10, 2021
Last updated
Dec 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Authorized official

Name
Christopher Hahn
Title
Operations
Phone
(304) 822-3838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

301 E Main St
Romney, WV 26757-1828

Mailing address

17978 State Road 55
Baker, WV 26801-8626
Phone (304) 897-5915

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL patientwebportal.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220407002079 WV Part A Provider - Federally Qualified Health Center (FQHC) 6204728041 Practice locations: Romney, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932868577. Details of each certification follow.

Federally qualified health center certification: CCN 581820

Legal name
E. A. HAWSE HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 11, 2022
Last certification
Feb 11, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 10, 1980 in WV
Enrollment address
301 E Main St
Romney, WV 26757-1828

Other NPIs with the same Medicare PAC ID 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Ea Hawse Health Center24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

17978 State Road 55
Baker, WV 26801
Phone (304) 897-8220

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Celesta Miller Individual Corporate DirectorBoard Member Dec 1, 2021 6.66%
Ralph Fitzwater Individual Corporate OfficerBoard President Dec 1, 2021 6.66%
Cheryl L Sherman Individual Operational/Managerial ControlBilling Supervisor Oct 1, 2018
Kristopher Kerr Individual Corporate DirectorBoard Member Dec 1, 2021 6.66%
Melissa Thompson Individual Operational/Managerial ControlCeo Jan 1, 2021 100%
Regina Whetzel Individual Corporate OfficerBoard Vice President Dec 1, 2021 6.66%

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1932868577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17978 STATE ROAD 55",
            "city": "BAKER",
            "state": "WV",
            "postal_code": "268018626",
            "telephone_number": "304-897-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "ROMNEY",
            "state": "WV",
            "postal_code": "267571828",
            "telephone_number": "304-897-5915",
            "fax_number": "304-897-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. A. HAWSE HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OPERATIONS",
        "authorized_official_telephone_number": "304-822-3838"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "patientwebportal.com",
            "affiliation": "N",
            "endpointDescription": "webportal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccd",
            "address_1": "301 E Main St",
            "city": "Romney",
            "state": "WV",
            "country_code": "US",
            "postal_code": "267571828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Romney, WV

Sources for this page

Verify at the official NPI Registry.