Monroe County Health Center Board of Trustees
Organization Active NPI Federally Qualified Health Center (FQHC) · Union, WV
NPI 1992734487 · NPPES record last updated Feb 10, 2011
Key facts
- NPI
- 1992734487
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- MONROE COUNTY HEALTH CENTER BOARD OF TRUSTEES
- Practice address
- 200 Health Center Drive
Union, WV 24983 - Phone
- (304) 772-3064
- Fax
- (304) 772-3296
- NPI assigned
- Jun 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Shannon Parker, MBA
- Title
- Ceo
- Phone
- (304) 772-3064
Owners & managing parties with NPI records 7
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 7
Related certifications (CCN) 1
Facilities with the same owner 1
Practitioners 32
-
Carrie Beard, DO
-
Jayne Ladier Canterbury, D.O.
-
James Warren Cunningham, M.A.
-
Lindsey Evans, FNP-BC
-
Steven K Jameson, DO
-
Robin Lynn Johnson, FNP-BC
-
Deborah Nolley, MS
-
Morgan Sams, FNP-BC
-
Sophia A Sibold, D.O.
-
John Carr Terry, MS
-
Alicia M Walker, M.A.
-
Darrioun Monte Webb, PSYD
-
Candice Marie Young, FNP-BC
-
John T. Hansbarger, M.D.
-
Erica Dowdy, PA
-
Jason L Howell, PA-C
-
Jennifer Anne Bailey, D.O.
-
Keri Galford, PA-C
-
Kevin Harper, LGSW
-
Ellen L. Lambert, FNP-BC
-
Angela Faye Martin, PNP
-
Kent Patrick, LPC
-
Katrina Ann Shires, NP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
Federally qualified health center certification: CCN 511837
- Legal name
- MONROE COUNTY HEALTH CENTER BOARD OF TRUSTEES
- Doing business as
- MONROE HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 1, 1993
- Last certification
- Jul 1, 1993
- Ownership / control type
- Non-profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 30, 2006 in WV
- Enrollment address
- 200 Health Center Drive
Union, WV 24983-0590
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Salvatore Bellassai |
Corporate Director | Jul 27, 2022 | |
| James Holtman |
Corporate Director | Sep 1, 2017 | |
| Richard Miller |
Corporate Director | Dec 1, 2020 | |
| James Nelson |
Corporate Director |
Dec 1, 2014 | |
| Vaden R Tabor |
Corporate Director | May 1, 2018 | |
| Wayne D Spangler |
Corporate Director | Dec 30, 2007 | |
| Scott King |
Corporate Director | Aug 25, 2021 | |
| Shirley H Dixon |
Corporate Director | Dec 30, 2007 | |
| Amy Mann |
Corporate Director | Apr 1, 2018 | |
| Monroe County Health Center Board of Trustees |
Operational/Managerial Control | Jun 30, 2006 | 100% |
| Walter Marsden |
Corporate Director | Jan 1, 2011 | |
| Janet W Caulkins |
Corporate Director | Dec 30, 2007 | |
| Michelle Ballard |
Corporate Director |
Dec 30, 2007 | |
| W-2 Managing Employee |
Dec 30, 2007 | ||
| Jeffry a Pritt |
Corporate Director | Dec 30, 2007 | |
| Melissa F Boggs |
Corporate Director | Dec 30, 2007 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Craig County Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Aug 30, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040330001675 | WV | Part B Supplier - Public Health/Welfare Agency | 3173432671 |
Receives reassigned benefits from 29 practitioners 5 other NPIs on this enrollment Practice locations: Union, WV; Peterstown, WV; Lindside, WV; Forest Hill, WV |
| O20110302000425 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 3173432671 | Practice locations: Union, WV |
National Provider Directory
Locations
226 Market St
New Castle, VA 24127
Phone (540) 863-6390
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | WV | Yes |
Addresses
Primary practice location
200 Health Center Drive
Union, WV 24983
Mailing address
200 Health Center Drive
PO Box 590
Union, WV 24983
Phone (304) 772-3064
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0035243000 | Medicaid | WV | |
| 001706775 | Other | WV | BC/BS |
| 5611053 | Other | WV | AETNA |
| DB2513 | Other | WV | MEDICARE RR GROUP |
Other names
- Monroe Health Center
Other providers in Union, WV
- Charles Matthews
- Melinda Ann McConnell
- Callie McMunigal
- Suzanne F Meadows
- Monroe County Health Center Board of Trustees
- Monroe Health Center-Union Lab
- Mountain View School
- Kathleen Mundell
- Panucci Orthodontics, PLLC
- Peterstown Wellness Center
All providers in Union, 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 Feb 10, 2011. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.