Grace Community Health Center Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GRACE COMMUNITY HEALTH CENTER INC

Doing business as

Knox County Area Technology Center School Based Health Clinic

Practice address

210 Wall St
Barbourville, KY 40906-1450

Phone

(606) 546-5320

NPI assigned

Dec 6, 2017

Last updated

Jun 28, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

GRACE COMMUNITY HEALTH CENTER INCAs reported in NPPES

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

Authorized official

Name

Chad Stevens

Title

Authorized Official

Phone

(606) 526-9005

Specialties & licenses 1

Addresses

Other names 1

• Knox County Area Technology Center School Based Health Clinic Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023523586. Details of each certification follow.

• CCN 181070 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 181070

Legal name

KNOX COUNTY AREA TECH CTR SCHOOL BASED HLTH CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 13, 2018

Last certification

Feb 13, 2018

Ownership / control type

For profit – corporation

Facility address

210 Wall St
Barbourville, KY 40906

Part of

Grace Community Health Center Inc

Locations

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1023523586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 CUMBERLAND FALLS HWY STE B201",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012793",
            "telephone_number": "606-526-9005",
            "fax_number": "606-526-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WALL ST",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061450",
            "telephone_number": "606-546-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRACE COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2017-12-06",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "606-526-9005"
    },
    "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": "Knox County Area Technology Center School Based Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alvin Gambrel, ATC
• Tammy Sue Gambrel, FNP
• Savanna Gilmore, MSW, CSW
• Gina Good, APRN
• Cynthia Goodin, APRN
• Grace Community Health Center Inc (Knox County Middle School Based Health Clinic)
• Grace Community Health Center Inc (G.R. Hampton Elementary School Based Health Clinic)
• Grace Community Health Center Inc (Central Elementary School Based Health Clinic)
• Grace Community Health Center Inc (Knox Central High School Based Health Clinic)
• Grace Community Health Center Inc (Appalachian Children's Home School Based Health Clinic)

• Federally Qualified Health Center (FQHC) in Barbourville, KY
• Providers in Barbourville, KY by specialty
• Federally Qualified Health Center (FQHC) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.