NPIMap

Organization Active NPI

Piedmont Access to Health Services, Inc

Doing business as Health Centers of the Piedmont South Boston

  • Federally Qualified Health Center (FQHC)
  • South Boston, VA
National Provider Identifier
1235677634
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PIEDMONT ACCESS TO HEALTH SERVICES, INC
Doing business as
Health Centers of the Piedmont South Boston
Practice address
2524 Houghton Ave
South Boston, VA 24592
Phone
(434) 575-1336
Fax
(434) 575-1349
NPI assigned
Feb 6, 2017
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Marsha Mendenhall
Title
Ceo
Phone
(434) 791-3630

Specialties & licenses 1

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

Addresses

Primary practice location

2524 Houghton Ave
South Boston, VA 24592

Mailing address

705 Main St
Danville, VA 24541-1803
Phone (434) 791-4122

Other names 1

  • Health Centers of the Piedmont South Boston Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170518002848 VA Part A Provider - Federally Qualified Health Center (FQHC) 3476512427 Practice locations: South Boston, VA
O20170920001334 VA Part B Supplier - Clinic/Group Practice 3476512427 Receives reassigned benefits from 32 practitioners
Practice locations: South Boston, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235677634. Details of each certification follow.

Federally qualified health center certification: CCN 491955

Legal name
PIEDMONT ACCESS TO HEALTH SERVICES INC
Doing business as
HEALTH CENTER OF THE PIEDMONT SOUTH BOSTON
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 20, 2017
Last certification
Mar 20, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 4, 2001 in VA
Enrollment address
2524 Houghton Ave
South Boston, VA 24592-2600

Other NPIs with the same Medicare PAC ID 11

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Brandie King Individual Corporate DirectorBoard Chair Dec 1, 2019
Rita Childress Individual Corporate DirectorBoard Vice Chair Aug 1, 2021
James Daniel Individual Corporate DirectorBoard Member Jul 1, 2021
Laura Luffman Individual Corporate DirectorBoard Member Nov 1, 2020
Clarence Kirby Individual Corporate DirectorBoard Treasurer Jul 1, 2016
Joanie Lynn Petty Individual Corporate DirectorBoard Member Aug 25, 2024
Rachel Boyer Individual Corporate DirectorBoard Secretary Jul 1, 2016
Ashley Jones Individual Corporate DirectorBoard Member Sep 24, 2025
Kathleen Bullano Individual Corporate DirectorBoard Member Jul 23, 2023
Tori Lester Individual Corporate DirectorCfo Jun 1, 2019
W-2 Managing EmployeeCfo Jun 1, 2019
Gregory G Braund Individual Corporate DirectorBoard Member Oct 1, 2021
Marsha Mendenhall Individual Corporate DirectorCeo Jun 1, 2019
Operational/Managerial ControlCeo Jun 1, 2019

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1235677634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 MAIN ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411803",
            "telephone_number": "434-791-4122",
            "fax_number": "434-791-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 HOUGHTON AVE",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "24592",
            "telephone_number": "434-575-1336",
            "fax_number": "434-575-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT ACCESS TO HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "MENDENHALL",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "434-791-3630"
    },
    "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": "Health Centers of the Piedmont South Boston",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Health Centers of the Piedmont South Boston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.