NPIMap

Organization Active NPI

St Charles Health Council Inc

Doing business as St Charles Respiratory Care Center

  • Federally Qualified Health Center (FQHC)
  • St. Charles, VA
National Provider Identifier
1215284153
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ST CHARLES HEALTH COUNCIL INC
Doing business as
St Charles Respiratory Care Center
Practice address
213 Monarch Road
St Charles, VA 24282
Phone
(276) 383-4428
Fax
(276) 383-4910
NPI assigned
Aug 9, 2012
Last updated
Jul 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Authorized official

Name
Malcolm Perdue
Title
Executive Director
Phone
(276) 546-5310

Specialties & licenses 1

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

Addresses

Primary practice location

213 Monarch Road
St Charles, VA 24282

Mailing address

276 Fieldstone Dr
Jonesville, VA 24263-1215
Phone (276) 546-5310

Other names 1

  • St Charles Respiratory Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121213000181 VA Part A Provider - Federally Qualified Health Center (FQHC) 0244124584 Practice locations: Saint Charles, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215284153. Details of each certification follow.

Federally qualified health center certification: CCN 491923

Legal name
ST. CHARLES HEALTH COUNCIL INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 14, 2012
Last certification
Dec 14, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1973 in VA
Enrollment address
213 Monarch Rd
Saint Charles, VA 24282-8122

Other NPIs with the same Medicare PAC ID 11

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

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
49D2142512St Charles Health Council213 Monarch Road, Saint Charles, VA 24282AccreditationNov 19, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Betty Rose Individual Corporate DirectorBoard Member May 21, 2001
Rufus C Hay Individual Corporate DirectorCoard Member Jun 6, 1994
Malcolm L Perdue Individual Corporate OfficerCeo Jul 1, 1998 100%
W-2 Managing EmployeePresident/Ceo Jul 1, 1998 100%
Violet J Martin Individual Corporate DirectorBoard Member Jun 16, 1996
Douglas McConnell Individual Corporate DirectorBoard Member Feb 23, 2010
Rebecca Johnson Individual Corporate DirectorBoard Member Jun 27, 2017
Mary K Edwards Individual Corporate DirectorBoard Member May 21, 1998
Sherry Lowe Individual Corporate Director Jun 27, 2017
Thelma B Harrington Individual Corporate DirectorBoard Member Apr 27, 2004
Gregory D Edwards Individual Corporate DirectorBoard Member Feb 7, 1995

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1215284153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 FIELDSTONE DR",
            "city": "JONESVILLE",
            "state": "VA",
            "postal_code": "242631215",
            "telephone_number": "276-546-5310",
            "fax_number": "276-546-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 MONARCH ROAD",
            "city": "ST CHARLES",
            "state": "VA",
            "postal_code": "24282",
            "telephone_number": "276-383-4428",
            "fax_number": "276-383-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CHARLES HEALTH COUNCIL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "PERDUE",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "276-546-5310"
    },
    "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": "St Charles Respiratory Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Charles Respiratory Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St. Charles, VA

Sources for this page

Verify at the official NPI Registry.