NPIMap

Organization Active NPI

Rockbridge Area Free Clinic

Doing business as RAHC Kendal Drive

  • Federally Qualified Health Center (FQHC)
  • Lexington, VA
National Provider Identifier
1194468553
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ROCKBRIDGE AREA FREE CLINIC
Doing business as
RAHC Kendal Drive
Practice address
170 Kendal Dr Ste a
Lexington, VA 24450-1786
Phone
(540) 464-8700
Fax
(855) 806-0826
NPI assigned
Apr 14, 2022
Last updated
Jan 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Valerie Suzanne Sheridan
Title
Ceo
Phone
(540) 464-8700

Specialties & licenses 1

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

Addresses

Primary practice location

170 Kendal Dr Ste a
Lexington, VA 24450-1786

Mailing address

25 Northridge LN
Lexington, VA 24450-3399
Phone (540) 464-8700

Other names 1

  • RAHC Kendal Drive Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL eCW Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230227003081 VA Part A Provider - Federally Qualified Health Center (FQHC) 2860626231 Practice locations: Lexington, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194468553. Details of each certification follow.

Federally qualified health center certification: CCN 491006

Legal name
ROCKBRIDGE AREA FREE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 27, 2023
Last certification
Feb 27, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 18, 1992 in VA
Enrollment address
170 Kendal Dr
Ste a
Lexington, VA 24450-1786

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Rockbridge Area Free Clinic6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Patricia Jones Individual Corporate Officer May 1, 2017
Jane T Horton Individual Corporate Officer May 1, 2015
David a Dugan Individual Corporate Officer May 1, 2020
Valerie Suzanne Sheridan Individual W-2 Managing Employee Feb 20, 2014
Operational/Managerial Control Feb 20, 2014
Dennis Cropper Individual Corporate Officer May 1, 2019

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1194468553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 NORTHRIDGE LN",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244503399",
            "telephone_number": "540-464-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 KENDAL DR STE A",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244501786",
            "telephone_number": "540-464-8700",
            "fax_number": "855-806-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKBRIDGE AREA FREE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "SUZANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "540-464-8700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "eCW",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIE",
            "address_1": "170 Kendal Dr Ste A",
            "city": "Lexington",
            "state": "VA",
            "country_code": "US",
            "postal_code": "244501786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "RAHC Kendal Drive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, VA

Sources for this page

Verify at the official NPI Registry.