Bland County Medical Clinic, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

BLAND COUNTY MEDICAL CLINIC, INC.

Doing business as

Orchard Creek Clinic

Practice address

8494 S Scenic Hwy
Bland, VA 24315-5255

Phone

(276) 688-0500

Fax

(276) 688-4336

NPI assigned

Jan 14, 2022

Last updated

Apr 26, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Gina Gail Goodman

Title

Credentialing & Enrollment/Outreach

Phone

(276) 688-4331

Specialties & licenses 1

Addresses

Other names 1

• Orchard Creek Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396496063. Details of each certification follow.

• CCN 491001 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 491001

Legal name

BLAND COUNTY MEDICAL CLINIC INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 7, 2022

Last certification

Jun 7, 2022

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

8494 S Scenic Hwy
Bland, VA 24315-5255

Other NPIs with the same Medicare PAC ID 1

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

• Bland County Medical Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bastian, VA
  • NPI 1104800671

  2264326453

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Bland County Medical Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bastian, VA
  • NPI 1104800671

  O20040210000077

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 10

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

Owners & managing parties with NPI records 1

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

• Bland County Medical Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bastian, VA
  • NPI 1104800671

  Operational/Managerial Control

  CMS ownership

Practitioners 24

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.

• Paige Marie Akers, D.M.D.

  • Dentist
  • Bland, VA
  • NPI 1861243115
  NPD
• Jennifer Suzanne Armstrong, FNP-BC

  • Family Nurse Practitioner
  • Bastian, VA
  • NPI 1568611556
  NPD
• Melissa Coleman, FNP

  • Family Nurse Practitioner
  • Bland, VA
  • NPI 1922766815
  NPD
• Mary Jo Collie, FNP C

  • Family Nurse Practitioner
  • Bastian, VA
  • NPI 1558451187
  NPD
• Pamela Sue Crowder, FNP-BC

  • Family Nurse Practitioner
  • Bastian, VA
  • NPI 1275074213
  NPD
• Deborah S Croy, NP

  • Family Nurse Practitioner
  • Bastian, VA
  • NPI 1174501993
  NPD
• Matthew Dellacona, D.O.

  • Family Medicine Physician
  • Tazewell, VA
  • NPI 1881033058
  NPD
• Vincent Filanova, D.D.S.

  • General Practice Dentistry
  • Bland, VA
  • NPI 1346376118
  NPD
• Mary A Grimmett, FNP-BC

  • Family Nurse Practitioner
  • Bastian, VA
  • NPI 1194362657
  NPD
• Courtney Heltzel, FNP-C

  • Family Nurse Practitioner
  • Bastian, VA
  • NPI 1457221012
  NPD
• Lindsey Heldreth Kennedy

  • Family Nurse Practitioner
  • Bastian, VA
  • NPI 1225568934
  NPD
• Carolyn Lundy King, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bluefield, VA
  • NPI 1477785392
  NPD

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1396496063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 GRAPEFIELD RD",
            "city": "BASTIAN",
            "state": "VA",
            "postal_code": "243144547",
            "telephone_number": "276-688-4331",
            "fax_number": "276-688-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8494 S SCENIC HWY",
            "city": "BLAND",
            "state": "VA",
            "postal_code": "243155255",
            "telephone_number": "276-688-0500",
            "fax_number": "276-688-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAND COUNTY MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-14",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "CREDENTIALING & ENROLLMENT/OUTREACH",
        "authorized_official_telephone_number": "276-688-4331",
        "authorized_official_name_prefix": "Mrs."
    },
    "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": "Orchard Creek Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paige Marie Akers, D.M.D.
• Sahar Alhusseini
• Bland County Volunteer Rescue Squad, Inc. (Bland County Rescue Squad)
• Bland Family Clinic PLLC
• Bland Family Dentistry, LTD.
• Bland Ministry Center, Inc.
• Melissa Coleman, FNP

• Federally Qualified Health Center (FQHC) in Bland, VA
• Providers in Bland, VA by specialty
• Federally Qualified Health Center (FQHC) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.