NPIMap

Organization Active NPI

Grace Community Health Center Inc

Doing business as Lynn Camp Elementary School Based Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
National Provider Identifier
1174038624
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GRACE COMMUNITY HEALTH CENTER INC
Doing business as
Lynn Camp Elementary School Based Health Clinic
Practice address
366 N Ky 830
Corbin, KY 40701-6132
Phone
(606) 523-1814
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

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

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

Addresses

Primary practice location

366 N Ky 830
Corbin, KY 40701-6132

Mailing address

1019 Cumberland Falls Hwy Ste B201
Corbin, KY 40701-2793
Phone (606) 526-9005

Other names 1

  • Lynn Camp Elementary School Based Health Clinic Doing business as

Medicare participation

Medicare enrollment files
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 1174038624. Details of each certification follow.

  • CCN 181074 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 181074

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LYNN CAMP ELEMENTARY SCHOOL BASED HEALTH 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
366 N Ky 830
Corbin, KY 40701

National Provider Directory

National Provider Directory
Part of
Grace Community Health Center Inc

Locations

366 N Ky 830
Corbin, KY 40701
Phone (606) 523-1814

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": "1174038624",
    "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": "366 N KY 830",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407016132",
            "telephone_number": "606-523-1814"
        }
    ],
    "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lynn Camp Elementary School Based Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.