NPIMap

Organization Active NPI

Rockbridge Area Free Clinic

Doing business as Rockbridge Area Health Center

  • Federally Qualified Health Center (FQHC)
  • Lexington, VA
National Provider Identifier
1205267002
Registry record updated Oct 17, 2022
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
Rockbridge Area Health Center
Practice address
25 Northridge LN
Lexington, VA 24450-3399
Phone
(540) 464-8700
Fax
(540) 464-1323
NPI assigned
Dec 3, 2013
Last updated
Oct 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

25 Northridge LN
Lexington, VA 24450-3399

Mailing address

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

Other practice location 1

2131 Magnolia Ave
Buena Vista, VA 24416-3111
Phone (540) 464-8700

Other names 1

  • Rockbridge Area Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131018000524 VA Part B Supplier - Clinic/Group Practice 2860626231 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
Practice locations: Lexington, VA
O20140228000412 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 1205267002. Details of each certification follow.

Federally qualified health center certification: CCN 491932

Legal name
ROCKBRIDGE AREA FREE CLINIC
Doing business as
ROCKBRIDGE AREA HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 28, 2014
Last certification
Feb 28, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 18, 1992 in VA
Enrollment address
25 Northridge Lane
Lexington, VA 24450-3399

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2062350Rockbridge Area Free Clinic25 Northridge Lane, Lexington, VA 24450Provider-performed microscopyFeb 18, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Josh McMichael Individual Corporate DirectorSecretary Feb 20, 2014
Jane T Horton Individual Corporate DirectorVP Feb 20, 2014
David a Dugan Individual Corporate DirectorPresident Feb 20, 2014
Valerie Suzanne Sheridan Individual W-2 Managing Employee Feb 20, 2014

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1205267002",
    "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",
            "fax_number": "540-464-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 NORTHRIDGE LN",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244503399",
            "telephone_number": "540-464-8700",
            "fax_number": "540-464-1323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2131 Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Buena Vista",
            "state": "VA",
            "postal_code": "244163111",
            "country_code": "US",
            "telephone_number": "540-464-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROCKBRIDGE AREA FREE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-03",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "SUZANNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "540-464-8700"
    },
    "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": "Rockbridge Area Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, VA

Sources for this page

Verify at the official NPI Registry.