NPIMap

Organization Active NPI

Bluegrass Primary Health Care Center, Inc.

Doing business as Bluegrass Community Health Center-George Rogers Clark HighSchoolClinic

  • Federally Qualified Health Center (FQHC)
  • Winchester, KY
National Provider Identifier
1447009303
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.
Doing business as
Bluegrass Community Health Center-George Rogers Clark HighSchoolClinic
Practice address
2745 Boonesboro Rd
Winchester, KY 40391-9291
Phone
(859) 259-2635
NPI assigned
May 14, 2024
Last updated
May 28, 2025By the provider in NPPES
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 Chowfhury
Title
Ceo
Phone
(859) 825-6869

Specialties & licenses 1

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

Addresses

Primary practice location

2745 Boonesboro Rd
Winchester, KY 40391-9291

Mailing address

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

Other names 1

  • Bluegrass Community Health Center-George Rogers Clark HighSchoolClinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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
O20240716003879 KY Part A Provider - Federally Qualified Health Center (FQHC) 7810326915 Practice locations: Winchester, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447009303. Details of each certification follow.

Federally qualified health center certification: CCN B01134

Legal name
BLUEGRASS PRIMARY HEALTH CARE CENTER, INC.
Doing business as
BLUEGRASS COMMUNITY HEALTH CENTER-GEORGE ROGERS CLARK HIGH SCHOOL CLIN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 26, 2024
Last certification
Jun 26, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 3, 2006 in KY
Enrollment address
2745 Boonesboro Rd
Winchester, KY 40391-9291

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

2745 Boonesboro Rd
Winchester, KY 40391
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 OfficerCfo Nov 1, 2022
W-2 Managing Employee Nov 1, 2022
John Ragland Individual Corporate DirectorBoard Member Sep 24, 2018
Alan S Wrightson Individual Corporate OfficerCeo Apr 25, 2016
Tina Huffman Individual Corporate DirectorBoard Member Apr 27, 2020
Marilynn Cunningham-Amos Individual Corporate DirectorBoard Member Sep 26, 2011
Paul Thornsberry Individual Corporate DirectorBoard Member Jun 23, 2014
Laura Sheffield Individual Corporate DirectorVice Chair Jun 28, 2021
Louise Harrell Individual Corporate DirectorTreasure Jan 24, 2022

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 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1447009303",
    "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": "2745 BOONESBORO RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403919291",
            "telephone_number": "859-259-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS PRIMARY HEALTH CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-14",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "CHOWFHURY",
        "authorized_official_first_name": "ENAYET",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "CEO",
        "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-George Rogers Clark HighSchoolClinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bluegrass Community Health Center-George Rogers Clark HighSchoolClinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winchester, KY

Sources for this page

Verify at the official NPI Registry.