NPIMap

Organization Active NPI

Grace Community Health Center Inc

Doing business as Girdler Elementary School Based Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Girdler, KY
National Provider Identifier
1407361967
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
Girdler Elementary School Based Health Clinic
Practice address
5452 N Ky 11
Girdler, KY 40943
Phone
(606) 546-4859
NPI assigned
Dec 6, 2017
Last updated
Jun 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GRACE COMMUNITY HEALTH CENTER INCAs reported in NPPES

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
Authorized Official
Phone
(606) 526-9005

Specialties & licenses 1

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

Addresses

Primary practice location

5452 N Ky 11
Girdler, KY 40943

Mailing address

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

Other names 1

  • Girdler Elementary School Based Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407361967. Details of each certification follow.

  • CCN 181060 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 181060

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GIRDLER ELEMENTARY SCHOOL BASED HEALTH CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 22, 2018
Last certification
Mar 22, 2018
Ownership / control type
For profit – corporation
Facility address
5452 N Ky 11
Girdler, KY 40943

National Provider Directory

National Provider Directory
Part of
Grace Community Health Center Inc

Practitioners & affiliated clinicians

Practitioners 5

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": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1407361967",
    "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": "606-526-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5452 N KY 11",
            "city": "GIRDLER",
            "state": "KY",
            "postal_code": "40943",
            "telephone_number": "606-546-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRACE COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2017-12-06",
        "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": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "606-526-9005"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Girdler Elementary School Based Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Girdler, KY

Sources for this page

Verify at the official NPI Registry.