NPIMap

Organization Active NPI

Grace Community Health Center, Inc.

Doing business as Grace Health Women's Care

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
National Provider Identifier
1386139749
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GRACE COMMUNITY HEALTH CENTER, INC.
Doing business as
Grace Health Women's Care
Practice address
1019 Cumberland Falls Hwy Ste D141
Corbin, KY 40701-2796
Phone
(606) 528-5527
NPI assigned
Jun 28, 2018
Last updated
Jun 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
Chad Stevens
Title
Chief Financial Officer
Phone
(606) 526-9005

Specialties & licenses 1

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

Addresses

Primary practice location

1019 Cumberland Falls Hwy Ste D141
Corbin, KY 40701-2796

Mailing address

1019 Cumberland Falls Hwy Ste B201
Corbin, KY 40701-2793
Phone (606) 526-9005

Other names 1

  • Grace Health Women's Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150306000699 KY Part A Provider - Federally Qualified Health Center (FQHC) 3870654064 1 other NPI on this enrollment
Practice locations: Corbin, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386139749. Details of each certification follow.

Federally qualified health center certification: CCN 181928

Legal name
GRACE COMMUNITY HEALTH CENTER, INC.
Doing business as
GRACE COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 23, 2015
Last certification
Feb 23, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 18, 2008 in KY
Enrollment address
1019 Cumberland Falls Hwy
Ste D141
Corbin, KY 40701-2796

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 1

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
18D2113038Grace Community Health Center Inc1019 Cumberland Falls Hwy, Corbin, KY 40701Provider-performed microscopyMay 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Grace Community Health Center Inc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Amy Russell Individual Corporate DirectorBoard Member Oct 31, 2018
Michael W Stanley Individual Corporate OfficerCeo Sep 17, 2012
W-2 Managing EmployeeCeo Sep 17, 2002
Roger West Individual Corporate DirectorBoard Member May 31, 2018
Damon Huff Individual Corporate DirectorBoard Member Jan 1, 2018
Karen a Hubbs Individual Corporate DirectorBoard Member Mar 22, 2016
Jeff W Hamlin Individual Corporate DirectorTreasurer May 1, 2012
Chad Stevens Individual Corporate OfficerCfo Aug 13, 2018 25%
W-2 Managing EmployeeCfo Aug 13, 2018
Alesia R Anderson Individual Corporate DirectorSr. Director of Community Programs Oct 1, 2014
W-2 Managing EmployeeSr. Director of Community Programs Oct 1, 2014
Operational/Managerial ControlSr. Director of Community Programs Oct 1, 2014
Hiram Cornett Individual Corporate DirectorVice Chairman Dec 1, 2012
Angela G Singley Individual Corporate DirectorBoard Member Jan 1, 2018
James Garrison Individual Corporate DirectorBoard Member Dec 31, 2016
Melvin Scarberry Individual Corporate DirectorChairman Oct 1, 2010
Franklin Gray Individual Corporate DirectorBoard Member Jun 30, 2016
Loretta Lyttle Individual Corporate DirectorBoard Member Jun 30, 2016
Melinda J Bowling Individual 5% Or Greater Direct Ownership Interest Jan 1, 2024 5%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1386139749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 CUMBERLAND FALLS HWY STE B201",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012793",
            "telephone_number": "606-526-9005",
            "fax_number": "606-528-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 CUMBERLAND FALLS HWY STE D141",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012796",
            "telephone_number": "606-528-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "606-526-9005"
    },
    "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": "Grace Health Women's Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grace Health Women's Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.