NPIMap

Organization Active NPI

Big Sandy Health Care, Inc

Doing business as Eden Elementary School Clinic

  • Federally Qualified Health Center (FQHC)
  • Inez, KY
National Provider Identifier
1043948516
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BIG SANDY HEALTH CARE, INC
Doing business as
Eden Elementary School Clinic
Practice address
179 Eden LN
Inez, KY 41224-8020
Phone
(606) 263-6500
Fax
(886) 927-9488
NPI assigned
Aug 11, 2022
Last updated
Feb 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Authorized official

Name
Debbie Colvin
Title
Credentialing Supervisor
Phone
(606) 886-8546

Specialties & licenses 1

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

Addresses

Primary practice location

179 Eden LN
Inez, KY 41224-8020

Mailing address

1709 Ky Route 321 Ste 3
Prestonsburg, KY 41653-9097
Phone (606) 886-8546

Other names 1

  • Eden Elementary School Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040510000841 KY Part B Supplier - Clinic/Group Practice 1951211218 Receives reassigned benefits from 72 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hi Hat, KY; Warfield, KY; Salyersville, KY; Pikeville, KY; Inez, KY; Harold, KY; Grethel, KY; Eastern, KY…
O20230112001824 KY Part A Provider - Federally Qualified Health Center (FQHC) 1951211218 Practice locations: Inez, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043948516. Details of each certification follow.

Federally qualified health center certification: CCN 181192

Legal name
BIG SANDY HEALTH CARE, INC
Doing business as
EDEN ELEMENTARY CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 13, 2022
Last certification
Dec 13, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 24, 1975 in KY
Enrollment address
179 Eden Lane
Inez, KY 41224-8020

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory
Tax ID family
Pikeville Community Pharmacy16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

179 Eden Ln
Inez, KY 41224
Phone (606) 263-6500

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Vicki Deskins Individual Corporate DirectorBoard Member Jul 25, 2022
James Herald Individual Corporate OfficerChief Executive Officer Nov 15, 2024
W-2 Managing EmployeeChief Executive Officer Nov 15, 2024
Gregory Napier Individual Corporate DirectorBoard Member Jun 27, 2022
Martha N Ellis Individual Corporate DirectorBoard Member Feb 26, 2024
Vicki Hunt Individual W-2 Managing EmployeeDirector of Reimbursement Aug 1, 2005
Roy Conley Individual Corporate DirectorBoard Member Aug 28, 2006
Amy Smith Individual Corporate DirectorBoard Member Sep 23, 2019
Bobby Hale Individual Corporate Director Jun 22, 2009
Kathy Hembree Individual Corporate DirectorBoard Member Oct 9, 1989
Thomas Callahan Individual Corporate DirectorBoard Member Jan 22, 2024
Kathy Trimble Individual Corporate DirectorBoard Member Jul 24, 2006
Melissa Turner Individual Corporate DirectorBoard Member Jul 27, 2015
Tina Terry Individual Corporate DirectorBoard Member Sep 26, 2011
Summer Morris Individual Corporate OfficerChief Financial Officer Nov 1, 2022
Joann Arnett Individual Corporate DirectorBoard Member Nov 1, 1988
Kimberly Daniels Individual Corporate DirectorBoard Member Feb 26, 2024
Mary McMasters Individual Corporate DirectorBoard Member Feb 27, 2012
Surekha Maddiwar Individual Corporate DirectorBoard Member Jan 1, 1993
James O'Bryan Individual Corporate DirectorBoard Member Jan 22, 2024
Linda Martin Individual Corporate DirectorBoard Member Jun 27, 2022
Michael Shoemaker Individual Corporate DirectorBoard Member Apr 27, 2009
Debbie Colvin Individual W-2 Managing EmployeeCredentialing Manager Nov 29, 2021
Wilbur Lindsey Individual Corporate DirectorBoard Member May 20, 2018
Mike Prater Individual Corporate DirectorBoard Member Jan 27, 2003

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1043948516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 KY ROUTE 321 STE 3",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416539097",
            "telephone_number": "606-886-8546",
            "fax_number": "606-886-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 EDEN LN",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412248020",
            "telephone_number": "606-263-6500",
            "fax_number": "886-927-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG SANDY HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-11",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "COLVIN",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "606-886-8546"
    },
    "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": "Eden Elementary School Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eden Elementary School Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inez, KY

Sources for this page

Verify at the official NPI Registry.