NPIMap

Organization Active NPI

Camc Greenbrier Valley Medical Center, Inc.

  • Optometrist
  • Ronceverte, WV
National Provider Identifier
1962287722
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CAMC GREENBRIER VALLEY MEDICAL CENTER, INC.
Practice address
1322 Maplewood Ave
Ronceverte, WV 24970-8016
Phone
(304) 347-5114
NPI assigned
Aug 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
Chad Hovis
Title
VP of Finance
Phone
(304) 388-6251

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Technician/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 156F00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246X00000X

Addresses

Primary practice location

1322 Maplewood Ave
Ronceverte, WV 24970-8016

Mailing address

400 Association Dr Ste 102
Charleston, WV 25311-1298
Phone (304) 388-1724

Other practice location 1

200 Mapplewood Ave
Ronceverte, WV 24970
Phone (304) 647-5114

Other practice location 2

3115 Seneca Trl S
Peterstown, WV 24963-5040
Phone (304) 753-9100

Other practice location 3

810 Grayson Ave
Covington, VA 24426-6353
Phone (304) 962-8227

Other names 1

  • CAMC GVMC Specialty Clinics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230118000113 WV Part B Supplier - Clinic/Group Practice 1254702962 Receives reassigned benefits from 139 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Summersville, WV; Ronceverte, WV; Rainelle, WV; Peterstown, WV; Oak Hill, WV; Lewisburg, WV; Beckley, WV
O20240221000458 VA Part B Supplier - Clinic/Group Practice 1254702962 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lowmoor, VA; Low Moor, VA; Covington, VA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Camc Greenbrier Valley Medical Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1 Arh Ln
Ste 700
Low Moor, VA 24457
Phone (540) 862-6750

10797 Seneca Trl S
Lindside, WV 24951
Phone (304) 753-4332

1322 Maplewood Ave
Ste A
Ronceverte, WV 24970
Phone (304) 647-1146

Practitioners & affiliated clinicians

Practitioners 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1962287722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ASSOCIATION DR STE 102",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111298",
            "telephone_number": "304-388-1724",
            "fax_number": "304-388-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 MAPLEWOOD AVE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708016",
            "telephone_number": "304-347-5114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mapplewood Ave",
            "address_purpose": "LOCATION",
            "city": "Ronceverte",
            "state": "WV",
            "postal_code": "24970",
            "country_code": "US",
            "telephone_number": "304-647-5114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3115 Seneca Trl S",
            "address_purpose": "LOCATION",
            "city": "Peterstown",
            "state": "WV",
            "postal_code": "249635040",
            "country_code": "US",
            "telephone_number": "304-753-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 Grayson Ave",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "VA",
            "postal_code": "244266353",
            "country_code": "US",
            "telephone_number": "304-962-8227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAMC GREENBRIER VALLEY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-30",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "HOVIS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "304-388-6251"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist Cardiovascular",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMC GVMC Specialty Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ronceverte, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.