NPIMap

Organization Active NPI

Community Health Centers of Western Kentucky, Inc.

  • Federally Qualified Health Center (FQHC)
  • Greenville, KY
National Provider Identifier
1306848650
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
700060 Issued in KY
Legal business name
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.
Practice address
480 Hopkinsville St
Greenville, KY 42345-1124
Phone
(270) 338-5777
Fax
(270) 338-5756
NPI assigned
Jun 1, 2005
Last updated
Apr 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Roger Arbuckle
Title
Ceo
Phone
(270) 338-5777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 700060 KY Primary

Addresses

Primary practice location

480 Hopkinsville St
Greenville, KY 42345-1124

Mailing address

480 Hopkinsville St
Greenville, KY 42345-1124
Phone (270) 338-5777

Other identifiers 2

IdentifierTypeStateIssuer
00000060638OtherKYANTHEM BLUE CROSS BLUE SH
31000458MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20050617000877 KY Part B Supplier - Clinic/Group Practice 5193769370 Receives reassigned benefits from 28 practitioners
5 other NPIs on this enrollment
Practice locations: Greenville, KY; Russellville, KY; Guthrie, KY
O20070703000720 KY Part A Provider - Federally Qualified Health Center (FQHC) 5193769370 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, KY
O20120927000630 KY Part A Provider - Federally Qualified Health Center (FQHC) 5193769370 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Russellville, KY
O20150424001908 KY Part A Provider - Federally Qualified Health Center (FQHC) 5193769370 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, KY
O20150811004523 KY Part A Provider - Federally Qualified Health Center (FQHC) 5193769370 Practice locations: Greenville, KY
O20170309000446 KY Part A Provider - Federally Qualified Health Center (FQHC) 5193769370 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Guthrie, KY

NPI to CCN mapping 5

The Medicare certification numbers (CCNs) connected to NPI 1306848650. Details of each certification follow.

Federally qualified health center certification: CCN 181865

Legal name
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 2, 2007
Last certification
Aug 2, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
226 Hopkinsville St
Greenville, KY 42345-1214

Federally qualified health center certification: CCN 181886

Legal name
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 28, 2012
Last certification
Sep 28, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 1994 in KY
Enrollment address
1497 Nashville St
Russellville, KY 42276-8850

Federally qualified health center certification: CCN 181930

Legal name
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 27, 2015
Last certification
Apr 27, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 1994 in KY
Enrollment address
504 Hopkinsville St
Greenville, KY 42345-1104

Federally qualified health center certification: CCN 181835

Legal name
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 14, 2000
Last certification
Apr 14, 2000
Ownership / control type
For profit – individual
Organization structure
CorporationNon-profit
Enrollment address
480 Hopkinsville St
Greenville, KY 42345-1124

Federally qualified health center certification: CCN 181012

Legal name
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 1, 2017
Last certification
Mar 1, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 1994 in KY
Enrollment address
10220 Dixie Beeline Hwy
Guthrie, KY 42234-9310

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 5

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
18D0901255Community Health Centers of Western Kentucky480 Hopkinsville St, Greenville, KY 42345Certificate of waiverFeb 6, 2028

National Provider Directory

National Provider Directory

Locations

10220 Dixie Beeline Hwy
Guthrie, KY 42234
Phone (270) 220-0340

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Marsha D Crowder Individual OtherOffice Manager Jun 15, 2015
Cary Davis Individual Corporate DirectorBoard Member Mar 1, 2012
Cindy Baird Individual Corporate DirectorBoard Member Mar 1, 2012
Rosemary Buck Individual Corporate DirectorBoard Member Mar 1, 2012
Corporate OfficerBoard Member Mar 1, 2012
Penelophie J Skipworth Individual OtherCredentialing/Billing Coordinato May 16, 2019
W-2 Managing EmployeeBilling Coordinator Dec 26, 2017
Billy Steele Individual Corporate DirectorBoard Member Mar 1, 2012
Richard Neathamer Individual Corporate DirectorBoard Member Mar 1, 2012
Jimmy Owens Individual Corporate DirectorBoard Member Oct 23, 2019
Amanda Henson Individual Corporate DirectorBoard Member Mar 27, 2019
Andrehia Hatfield Individual Corporate DirectorBoard Member Mar 1, 2012
Roger a Arbuckle Individual Corporate OfficerCeo Mar 1, 2012
W-2 Managing EmployeeCeo Mar 26, 2007
Corporate OfficerCeo Jun 1, 1998
W-2 Managing Employee Mar 1, 2012
Lindsay B Durall Individual Corporate OfficerCfo Feb 1, 2021
Elizabeth Gentry Individual Corporate DirectorBoard Member Mar 1, 2012
Tamara C Harvey Individual W-2 Managing EmployeeBilling Mar May 27, 2025
W-2 Managing EmployeeOffice MGR Mar 1, 2012
W-2 Managing EmployeeBilling MGR/Delegated Official Jun 19, 2025
W-2 Managing EmployeeOffice Business MGR Jun 1, 2012
Elizabeth Eaves Individual Corporate DirectorBoard Member Mar 1, 2012
Molly Alward Individual Corporate OfficerBoard Member May 15, 2015

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1306848650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 HOPKINSVILLE ST",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451124",
            "telephone_number": "270-338-5777",
            "fax_number": "270-338-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 HOPKINSVILLE ST",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451124",
            "telephone_number": "270-338-5777",
            "fax_number": "270-338-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "ARBUCKLE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-338-5777"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "KY",
            "license": "700060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "00000060638",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31000458",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, KY

Sources for this page

Verify at the official NPI Registry.