NPIMap

Organization Active NPI

Camden on Gauley Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Craigsville, WV
National Provider Identifier
1942013487
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CAMDEN ON GAULEY MEDICAL CENTER INC
Practice address
215 Milam Addition Rd
Craigsville, WV 26205-8569
Phone
(304) 226-5725
Fax
(304) 226-3274
NPI assigned
Jan 29, 2025
Organization subpart
Yes
Parent organization
CAMDEN ON GAULEY MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Margaret Hickey
Title
Ceo
Phone
(304) 226-5725

Specialties & licenses 1

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

Addresses

Primary practice location

215 Milam Addition Rd
Craigsville, WV 26205-8569

Mailing address

10003 Webster Rd
Camden on Gauley, WV 26208-7713
Phone (304) 226-5725

Other names 1

  • Camden Family Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250224002983 WV Part B Supplier - Clinic/Group Practice 6002867850 Receives reassigned benefits from 8 practitioners
Practice locations: Craigsville, WV
O20251105000863 WV Part A Provider - Federally Qualified Health Center (FQHC) 6002867850 Practice locations: Craigsville, WV

Federally qualified health center certification: CCN 581079

Legal name
CAMDEN ON GAULEY MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 22, 2025
Last certification
Jul 22, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
215 Milam Addition Rd
Craigsville, WV 26205-8569

Other NPIs with the same Medicare PAC ID 24

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

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Camden on Gauley Medical Center Inc21 organizations share this tax ID, including this one
Part of
Camden on Gauley Medical Center Inc

Other organizations with this tax ID 20

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

View all 20

Locations

74 Technology Ln
Cowen, WV 26206
Phone (304) 226-5527

215 Milam Addition Rd
Craigsville, WV 26205

1945 E Mount Lookout Rd
Mount Lookout, WV 26678

58 E Main St
Richwood, WV 26261
Phone (304) 846-2608

165 Country Rd
Summersville, WV 26651

7950 Webster Rd
Summersville, WV 26651

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Roy Moose Individual Corporate DirectorBoard Member Jan 1, 2010
Elizabeth Snyder Individual Corporate DirectorBoard Member Jan 1, 1997
Barbara Butler Individual Corporate DirectorBoard Member Nov 18, 2019
Brandon Moll Individual Corporate DirectorBoard Member Aug 12, 2022
Sharon Hanna Individual Corporate DirectorBoard Member Jan 1, 1981
Margaret Hickey Individual Corporate OfficerCeo Mar 1, 2011
W-2 Managing EmployeeCeo Mar 1, 2011
Operational/Managerial ControlCeo Mar 1, 2011
James Gamble Individual Corporate DirectorBoard Member Jan 1, 1989
Michael Schartiger Individual Corporate DirectorBoard Member Nov 25, 2024
Melissa Rogers Individual Corporate OfficerCoo Sep 7, 2007
Tiffany Montgomery Individual Corporate DirectorBoard Member Mar 22, 2021
Jane Sherwood Individual Corporate DirectorBoard Member Aug 1, 2020

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Camden Family HealthCraigsville, WV, CCN 511091 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Nov 1, 1979
Camden on Gauley Medical Center IncSummersville, WV, CCN 511145 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Nov 1, 1979

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1942013487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10003 WEBSTER RD",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262087713",
            "telephone_number": "304-226-5725",
            "fax_number": "304-226-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MILAM ADDITION RD",
            "city": "CRAIGSVILLE",
            "state": "WV",
            "postal_code": "262058569",
            "telephone_number": "304-226-5725",
            "fax_number": "304-226-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMDEN ON GAULEY MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMDEN ON GAULEY MEDICAL CENTER INC",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "HICKEY",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-226-5725"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camden Family Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Craigsville, WV

Sources for this page

Verify at the official NPI Registry.