Family Health Care Associates 9
Organization Active NPI Rural Health Clinic/Center · Williamsburg, KY
NPI 1447904875 · NPPES record last updated May 18, 2023
Key facts
- NPI
- 1447904875
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- FAMILY HEALTH CARE ASSOCIATES 9
- Practice address
- 2932 N Highway 25 W
Williamsburg, KY 40769-8633 - Phone
- (606) 546-7777
- NPI assigned
- Feb 4, 2022
- Organization subpart
- No
Authorized official
- Name
- Gina Good, APRN
- Title
- Owner/Ceo
- Phone
- (606) 546-7777
Owners & managing parties with NPI records 1
-
Gina Good, APRN
Practitioners 14
-
Lisa Grubb, APRN
-
Betty Alevras, APRN
-
Jill L Bryant, APRN
-
Gina Good, APRN
-
Heather Marie Hammack, APRN, FNP-C
-
Rebecca Ann Hensley, M.S.N., R.N., PNP-BC
-
Carolyn F McFarland, APRN, FNP, PMHNP-BC
-
Joyce A Parker, APRN, NP-C
-
Sheryl Partin, NP
-
Samantha Brooke Shell, APRN
-
Vannessa Marie Watson, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Rural health clinic certification: CCN B03946
- Legal name
- FAMILY HEALTH CARE ASSOCIATES 9
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 3, 2024
- Last certification
- Jan 3, 2024
- Ownership / control type
- 1A
- Organization structure
- LLC · Proprietary
- Incorporated
- Jan 31, 2022 in KY
- Enrollment address
- 3080 N Highway 25 W
Williamsburg, KY 40769-8602
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Gina Good |
5% Or Greater Direct Ownership Interest |
Jan 31, 2022 | 100% |
| Operational/Managerial Control |
Jan 17, 2022 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220414001515 | KY | Part a Provider - Rural Health Clinic | 4183010390 | Practice locations: Williamsburg, KY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
2932 N Highway 25 W
Williamsburg, KY 40769-8633
Mailing address
PO Box 1535
Barbourville, KY 40906-5535
Other providers in Williamsburg, KY
- Eagle Health & Wellness, Inc.
- Christy Renee Elliott
- Rachel Nicole Ellison
- Teresa Ruth Ellison
- Jennifer Marie Emery
- Family Health Care Associates of Williamsburg
- Kayla Fields
- Shala Foley
- Cynthia Eileen Fults
- Warren Brooks Gardner
All providers in Williamsburg, KY · Rural Health Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.