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Bluestone Health Association, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Princeton, WV

NPI 1437508314 · NPPES record last updated Feb 24, 2021

Key facts

NPI
1437508314
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
2WV7X5S256 (WV)
Legal business name
BLUESTONE HEALTH ASSOCIATION, INC.
Practice address
324 Oakvale Rd Ste 12
Princeton, WV 24740-3829
Phone
(681) 282-5576
Fax
(681) 282-5583
NPI assigned
Jun 10, 2016
Organization subpart
Yes
Parent organization (as reported)
BLUESTONE HEALTH ASSOCIATION, INC.

Authorized official

Name
Linda Hutchens
Title
Ceo
Phone
(304) 431-5499

Other NPIs with the same Medicare PAC ID 6

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

Practitioners 41

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

View all 41

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WV

Federally qualified health center certification: CCN 511105

Legal name
BLUESTONE HEALTH ASSOCIATION, INC.
Doing business as
BLUESTONE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 5, 2016
Last certification
Jul 5, 2016
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Apr 19, 1976 in WV
Enrollment address
324 Oakvale Rd
Ste 12
Princeton, WV 24740-3829

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Janet G Shrewsbury
Individual 		Other
Board Member		 May 1, 2024
Charles Wolfe
Individual 		Other
Board Member		 May 1, 2024
Nathan Hendrick
Individual 		Other
Board Member		 May 1, 2024
Norman Fletcher
Individual 		Other
Board Member		 Jan 1, 1995
Norma Clark
Individual 		Other
Board Member		 Jan 1, 2010
Carmen Hendrick
Individual 		Other
Board Member		 May 1, 2024
Brittani Hutchens
Individual 		Corporate Director
Chief Executive Officer		 May 31, 2024
W-2 Managing Employee
Ad;		 May 31, 2024
Kurt Rice
Individual 		Other
Board Member		 Sep 1, 2021
Marsha Howell
Individual 		Other
Board Member		 Jan 1, 1986
Mary Joann Dixon
Individual 		Other
Board Member		 Nov 30, 2020
Melanie Jessee
Individual 		Other
Board Member		 Oct 22, 2012

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160815002864 WV Part a Provider - Federally Qualified Health Center (FQHC) 3577505221 Practice locations: Princeton, WV
O20161017000342 WV Part B Supplier - Clinic/Group Practice 3577505221 Receives reassigned benefits from 38 practitioners
Practice locations: Princeton, WV

National Provider Directory

Part of
Bluestone Health Center Pharmacy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 2WV7X5S256 WV Yes

Addresses

Primary practice location

324 Oakvale Rd Ste 12
Princeton, WV 24740-3829

Mailing address

3997 Beckley Rd
Princeton, WV 24740-7660
Phone (304) 431-5499

Other names

  • Bluestone Medical Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 24, 2021.

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1437508314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3997 BECKLEY RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247407660",
            "telephone_number": "304-431-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 OAKVALE RD STE 12",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403829",
            "telephone_number": "681-282-5576",
            "fax_number": "681-282-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUESTONE HEALTH ASSOCIATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUESTONE HEALTH ASSOCIATION, INC.",
        "enumeration_date": "2016-06-10",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "HUTCHENS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-431-5499"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WV",
            "license": "2WV7X5S256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluestone Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bluestone Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, WV

All providers in Princeton, WV · Federally Qualified Health Center (FQHC) in West Virginia

Sources for this page

Verify at the official NPI Registry.