Grace Community Health Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GRACE COMMUNITY HEALTH CENTER INC

Practice address

121 Bishop St
Corbin, KY 40701-1702

Phone

(606) 528-2124

Fax

(606) 528-8272

NPI assigned

Apr 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

Michael W Stanley

Title

Ceo

Phone

(606) 526-9005

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Grace Community Health Center Inc

  dba Falls Hwy Clinic

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
  • NPI 1508308560

  O20081211000571

  Same enrollment
• Grace Community Health Center Inc

  dba Hyden Clinic

  • Federally Qualified Health Center (FQHC)
  • Hyden, KY
  • NPI 1598207557

  O20081211000571

  Same enrollment
• Grace Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wooton, KY
  • NPI 1235486531

  O20081211000571

  Same enrollment
• Grace Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
  • NPI 1568625648

  O20081211000571

  Same enrollment
• Grace Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Manchester, KY
  • NPI 1902048481

  O20081211000571

  Same enrollment

Part of

Grace Community Health Center Inc

Locations

Practitioners 1

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.

• John Michael Watts, M.D.

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1104884451
  NPD

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1174056261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 CUMBERLAND FALLS HWY",
            "address_2": "SUITE B201",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012735",
            "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": "121 BISHOP ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011702",
            "telephone_number": "606-528-2124",
            "fax_number": "606-528-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRACE COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2017-04-06",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-526-9005"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette L. Goodin, D.I
• Thomas Wayne Goodin Jr., PHARMD
• Grace (Grace Health Pharmacy-Medical Campus)
• Grace Community Health Center Inc (Bishop Street Pharmacy)
• Grace Community Health Center Inc (Lynn Camp Elementary School Based Health Clinic)
• Grace Community Health Center Inc (Corbin High School Based Health Clinic)
• Grace Community Health Center Inc (Lynn Camp Middle/High School Based Health Clinic)
• Grace Community Health Center Inc (Corbin Elementary School Based Health Clinic)
• Grace Community Health Center Inc (Corbin School of Innovation)
• Grace Community Health Center Inc (Falls Hwy Clinic)

• Family Medicine Physician in Corbin, KY
• Providers in Corbin, KY by specialty
• Family Medicine Physician 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.