NPIMap

Organization Active NPI

Mountain Comprehensive Health Corporation

  • Primary Care Clinic/Center
  • Neon, KY
National Provider Identifier
1295082386
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Practice address
50 2ND St
Neon, KY 41840-8994
Phone
(606) 633-4823
Fax
(606) 633-1874
NPI assigned
Aug 8, 2012
Organization subpart
No

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 24

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

View all 24

Practitioners 82

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 82

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121228000474 KY Part A Provider - Federally Qualified Health Center (FQHC) 7618875873 Practice locations: Neon, KY

Federally qualified health center certification: CCN 181897

Legal name
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 29, 2012
Last certification
Dec 29, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 14, 1972 in KY
Enrollment address
50 2ND St
Neon, KY 41840-8994

All disclosed owners & managing parties 17

Medicare enrollment files

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

NameRoleSinceShare
Sherry Childers Individual Corporate DirectorBoard Treasurer Jan 1, 2024
Steve Peake Individual Corporate DirectorBoard Member Jul 20, 2022
William Parks Individual Corporate DirectorBoard Member Jan 1, 2018
Jerry Hall Individual Corporate DirectorBoard Member Jan 1, 2022
Mike Caudill Individual Corporate OfficerChief Executive Officer Jul 1, 2005
David Adams Individual Corporate DirectorBoard Member Jan 1, 2016
Teresa Dotson Individual Corporate OfficerChief Operating Officer Sep 8, 2025
W-2 Managing EmployeeChief Operating Officer Sep 8, 2025
Charles Colwell Individual Corporate DirectorBoard Member Jan 1, 2025
Gwen Johnson Individual Corporate DirectorBoard Member Jan 1, 2025
Jackie Colwell Individual Corporate DirectorBoard Member Jan 1, 2018
Teresa Hunter Individual Corporate DirectorBoard Member Jan 1, 2025
Mary Ann Sparks Individual Corporate DirectorBoard Member Jan 1, 2020
Paul Pratt Individual Corporate DirectorChairman of the Board Jan 1, 2023
Nanette Banks Individual Corporate DirectorBoard Secretary Jan 1, 2023
Robert Musick Individual Corporate DirectorBoard Member Sep 17, 2024
Carlana G. Mullins Individual Corporate DirectorBoard Member Jan 1, 2013
Kathy Hall Individual Corporate DirectorVice-Chairman of the Board Jan 1, 2016

All facility ownership & control disclosures 4

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mountain Comprehensive Health CorporationWhitesburg, KY, CCN 181893 Federally qualified health center Operational/Managerial Control Aug 1, 2012
Letcher County Alternative Education School Based ClinicWhitesburg, KY, CCN 181892 Federally qualified health center Operational/Managerial Control Aug 1, 2012
Mountain Comprehensive Health CorporationLetcher, KY, CCN 181891 Federally qualified health center Operational/Managerial Control Aug 1, 2012
Mountain Comprehensive Health CorporationWhitesburg, KY, CCN 181894 Federally qualified health center Operational/Managerial Control Aug 1, 2012

National Provider Directory

National Provider Directory
Tax ID family
MTN Comp Health Corp35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
L.M. (Mike) Caudill
Title
Ceo
Phone
(606) 633-4823

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X
Primary Care Clinic/Center 261QP2300X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

50 2ND St
Neon, KY 41840-8994

Mailing address

PO Box 40
Whitesburg, KY 41858-0040

NPI Registry JSON

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1295082386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418580040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 2ND ST",
            "city": "NEON",
            "state": "KY",
            "postal_code": "418408994",
            "telephone_number": "606-633-4823",
            "fax_number": "606-633-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN COMPREHENSIVE HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "CAUDILL",
        "authorized_official_first_name": "L.M. (MIKE)",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-633-4823"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neon, KY

Sources for this page

Verify at the official NPI Registry.