BROADDUS HOSPITAL ASSOCIATION, INC. (NPI# 1104989466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104989466 |
| Entity Type | Organization |
| Organization Name | BROADDUS HOSPITAL ASSOCIATION, INC. |
| Other Organization Name | BROADDUS HOSPITAL (SWING BED) |
| Practice Address |
#1 Healthcare Drive Mansfield Hill Philippi WV 26416 |
| Practice Telephone | 3044571760 |
| Practice Fax Number | 3044571516 |
| Mailing Telephone | 3044571760 |
| Mailing Fax Number | 3044571516 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2019-07-09 |
| Authorized Official Name | MRS. DANA L. GOULD (CEO) |
| Authorized Official Telephone | 3044571760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 96 | WV | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0002167001 | 05 |
| Other Name | Type Code |
|---|---|
| Broaddus Hospital (Swing Bed) | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215097613 | Broaddus Hospital Association, Inc. | Skilled Nursing Facility | #5 Healthcare Drive, Mansfield Hill, Philippi, WV 26416 | 2006-12-08 |
| 1548246622 | Broaddus Hospital Association, Inc. | General Acute Care Hospital | #1 Healthcare Drive, Mansfield Hill, Philippi, WV 26416 | 2005-12-20 |
| Street Address |
#1 HEALTHCARE DRIVE MANSFIELD HILL |
| City | PHILIPPI |
| State | WV |
| Zip Code | 26416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548246622 | Broaddus Hospital Association, Inc. | General Acute Care Hospital | #1 Healthcare Drive, Mansfield Hill, Philippi, WV 26416 | 2005-12-20 |
| 1609033844 | Marwan Marc Dib | Physician Assistant | #1 Healthcare Drive, Philippi, WV 26416 | 2008-05-16 |
| 1528116662 | Larry L Fitzwater | Physician Assistant | #1 Healthcare Drive, Philippi, WV 26416 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558977595 | Ralph House | Counselor | Barbour County Health Department, 109 Wabash Ave, Philippi, WV 26416 | 2020-09-16 |
| 1902418601 | Wendy Gregory | Technician | 63 Judy Lane, Philippi, WV 26416 | 2020-08-24 |
| 1922610005 | Miranda Mullen | Case Manager/Care Coordinator | 10 Parkview Drive, Philippi, WV 26416 | 2020-08-19 |
| 1750765095 | Katie Cox | Home Health Aide | 531 S Main Street, Philippi, WV 26416 | 2015-07-16 |
| 1225438252 | Michael Joseph Boehke | Specialist/Technologist | 101 College Hill Drive, Box 2061, Philippi, WV 26416 | 2014-08-27 |
| 1487941712 | Ryan Andrew Hardesty | Pharmacist | 101-103 South Main Street, Philippi, WV 26416 | 2011-07-07 |
| 1225328685 | Dawn Margaret Scheick | Registered Nurse | 23 Wabash St, Barbour Co Health Dept. Behavioral Health, Philippi, WV 26416 | 2011-04-19 |
| 1881902864 | Dianne Adrian Byrer | Counselor | 23 Wabash Avenue, Philippi, WV 26416 | 2010-09-23 |
| 1205096039 | Belington Community Medical Services Association, Inc. | Clinic/Center | 99 Horseshoe Dr, Philippi, WV 26416 | 2008-06-16 |
| 1922295062 | Broaddus Hospital Group | General Acute Care Hospital | #1 Health Care Drive, Philippi, WV 26416 | 2007-10-03 |
| Find all providers in zip 26416 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063509263 | Hospital Development Co. | Medicare Defined Swing Bed Unit | 200 Hospital Drive, Spencer, WV 25276 | 2006-10-07 |
| 1598763666 | Grant Memorial Hospital | Medicare Defined Swing Bed Unit | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2005-07-12 |
| 1649277476 | Community Health Association | Medicare Defined Swing Bed Unit | 122 Pinnell Street, Ripley, WV 25271-0720 | 2005-07-07 |
| 1730788399 | Marietta Memorial Hospital of Tyler County Inc | Medicare Defined Swing Bed Unit | 314 S Wells St, Sistersville, WV 26175-1098 | 2020-10-23 |
| 1376175240 | Wetzel County Hospital, Inc. | Medicare Defined Swing Bed Unit | 3 E Benjamin Dr, New Martinsville, WV 26155-2758 | 2020-02-10 |
| 1891350179 | Bluefield Hospital Company LLC | Medicare Defined Swing Bed Unit | 500 Cherry St, Bluefield, WV 24701-3306 | 2019-05-02 |
| 1407223571 | Lindsey M Tabor | Medicare Defined Swing Bed Unit | 324 Miller Mountain Dr, Webster Springs, WV 26288-1065 | 2015-08-25 |
| 1104242569 | Jefferson Memorial Hospital | Medicare Defined Swing Bed Unit | 300 S Preston St, Ranson, WV 25438-1631 | 2014-03-10 |
| 1982836326 | Montgomery General Hospital, Inc | Medicare Defined Swing Bed Unit | 401 Sixth Avenue, Montgomery, WV 25136-2116 | 2009-08-19 |
| 1437391414 | Grant Memorial Hospital | Medicare Defined Swing Bed Unit | 1 Hospital Dr, Petersburg, WV 26847-9549 | 2009-04-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.