NPIMap

Organization Active NPI

Bluegrass Primary Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
National Provider Identifier
1356972764
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BLUEGRASS PRIMARY HEALTH CARE CENTER, INC.
Practice address
131 N Eagle Creek Dr
Lexington, KY 40509-1806
Phone
(859) 263-2507
Fax
(859) 254-7874
NPI assigned
Feb 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Mr. Enayet U Chowdhury
Title
Chief Executive Officer
Phone
(859) 825-6869

Specialties & licenses 1

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

Addresses

Primary practice location

131 N Eagle Creek Dr
Lexington, KY 40509-1806

Mailing address

1306 Versailles Rd Ste 120
Lexington, KY 40504-1795
Phone (859) 259-2635

Other names 2

  • Bluegrass Community Health Center-Eagle Creek Doing business as
  • Bluegrass Community Health Center-Mobile Van 1 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200409003475 KY Part A Provider - Federally Qualified Health Center (FQHC) 7810326915 Practice locations: Lexington, KY
O20200509000222 KY Part B Supplier - Clinic/Group Practice 7810326915 Receives reassigned benefits from 23 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lexington, KY; Winchester, KY

Federally qualified health center certification: CCN 181195

Legal name
BLUEGRASS PRIMARY HEALTH CARE CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 10, 2020
Last certification
Apr 10, 2020
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Oct 3, 2006 in KY
Enrollment address
131 N Eagle Creek Dr
Lexington, KY 40509-1806

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 6

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

National Provider Directory

National Provider Directory
Tax ID family
Bluegrass Community Health Center Pharmacy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

151 N Eagle Creek Dr
Ste 220
Lexington, KY 40509
Phone (859) 259-2635

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Stephen Clark Individual Corporate OfficerCeo Nov 1, 2022
W-2 Managing Employee Nov 1, 2022
John Ragland Individual Corporate Director Sep 24, 2018
Enayet U Chowdhury Individual Corporate OfficerCeo Apr 7, 2025
Tina Huffman Individual Corporate DirectorBoard Member Apr 7, 2020
Laura Sheffield Individual Corporate OfficerBoard Member Jun 28, 2021
Louise Harrell Individual Corporate OfficerBoard Member Jan 24, 2022
Jacob Ferrington Individual Corporate Director May 28, 2024
Leigh Nuckols Individual Corporate DirectorBoard Member Apr 29, 2025

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1356972764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 VERSAILLES RD STE 120",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405041795",
            "telephone_number": "859-259-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091806",
            "telephone_number": "859-263-2507",
            "fax_number": "859-254-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS PRIMARY HEALTH CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-04",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "CHOWDHURY",
        "authorized_official_first_name": "ENAYET",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "859-825-6869",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluegrass Community Health Center-Eagle Creek",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bluegrass Community Health Center-Eagle Creek",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bluegrass Community Health Center-Mobile Van 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.