NPIMap

Organization Active NPI

Preston-Taylor Community Health Centers, Incorporated

Doing business as Taylor County Middle School-SBHC

  • Federally Qualified Health Center (FQHC)
  • Grafton, WV
National Provider Identifier
1942076427
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRESTON-TAYLOR COMMUNITY HEALTH CENTERS, INCORPORATED
Doing business as
Taylor County Middle School-SBHC
Practice address
670 Spring Hills Rd
Grafton, WV 26354-7446
Phone
(304) 265-0722
NPI assigned
Nov 27, 2023
Last updated
Dec 14, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PRESTON TAYLOR COMMUNITY HEALTH CENTERS INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Authorized official

Name
Beverly J. Snyder
Title
Executive Assistant
Phone
(304) 265-0312

Specialties & licenses 1

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

Addresses

Primary practice location

670 Spring Hills Rd
Grafton, WV 26354-7446

Mailing address

25 W Bluemont St
Grafton, WV 26354-1242
Phone (304) 265-0312

Other names 1

  • Taylor County Middle School-SBHC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240226003126 WV Part A Provider - Federally Qualified Health Center (FQHC) 3072406438 Practice locations: Grafton, WV
O20240416000818 WV Part B Supplier - Other 3072406438 Receives reassigned benefits from 4 practitioners
Practice locations: Grafton, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942076427. Details of each certification follow.

Federally qualified health center certification: CCN 581034

Legal name
PRESTON TAYLOR COMMUNITY HEALTH CENTERS, INCORPORATED
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 26, 2024
Last certification
Feb 26, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 16, 1986 in WV
Enrollment address
670 Spring Hills Rd
Grafton, WV 26354-7446

Other NPIs with the same Medicare PAC ID 7

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2297426Taylor County Middle School - SBHC670 Spring Hills Road, Grafton, WV 26354Certificate of waiverJan 16, 2028

National Provider Directory

National Provider Directory
Tax ID family
Preston Taylor Community Health Centers Incorporated15 organizations share this tax ID, including this one
Part of
Preston Taylor Community Health Centers Incorporated

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Vonda Reneman Individual Corporate DirectorBoard Member Jan 1, 2019
Karen Temple Individual Corporate DirectorBoard Member Apr 27, 2023
Mark Teets Individual Corporate DirectorBoard Member Oct 1, 2022
Elizabeth June Griffith Individual Corporate OfficerCeo Jan 16, 2022 100%
W-2 Managing EmployeeCeo Jan 16, 2022 100%
Doug Lyons Individual Corporate DirectorBoard Member Sep 21, 2009
Patrick a Nichols Individual Corporate DirectorBoard Member Sep 27, 2001
Tony Veltri Individual Corporate DirectorBoard Member Jun 1, 1986
Hunter B Mullens Individual Corporate DirectorBoard Member Jun 25, 1997

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Community Eye CareGrafton, WV, CCN 581043 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 1, 2024
Mar 1, 2024

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1942076427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W BLUEMONT ST",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "263541242",
            "telephone_number": "304-265-0312",
            "fax_number": "304-265-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 SPRING HILLS RD",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "263547446",
            "telephone_number": "304-265-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTON-TAYLOR COMMUNITY HEALTH CENTERS, INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESTON TAYLOR COMMUNITY HEALTH CENTERS INCORPORATED",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "304-265-0312"
    },
    "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": "Taylor County Middle School-SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grafton, WV

Sources for this page

Verify at the official NPI Registry.