Community Memorial Healthcenter

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

COMMUNITY MEMORIAL HEALTHCENTER

Practice address

61 Burlington Dr
Clarksville, VA 23927-3235

Phone

(434) 774-2400

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Elizabeth Allen

Title

Vice President

Phone

(804) 628-1338

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clarksville Primary Care Center Doing business as

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

CLIA laboratory certificates

Practitioners 1

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

• Willoughby Shelton Hundley III, M.D.

  • Emergency Medicine Physician
  • Boydton, VA
  • NPI 1457328767
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1487736864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1716",
            "city": "CLARKSVILLE",
            "state": "VA",
            "postal_code": "239271716",
            "telephone_number": "434-774-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BURLINGTON DR",
            "city": "CLARKSVILLE",
            "state": "VA",
            "postal_code": "239273235",
            "telephone_number": "434-774-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HEALTHCENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "804-628-1338"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007610777",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarksville Primary Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarksville Primary Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clarksville Senior Care, LLC
• Clarksville Senior Care, LLC
• Allyson Michelle Collins, MS, LPC
• Brianna Collins
• Ashley Combs
• Rosemary Cosselmon, LPC
• Donna Kay Dawson, PT, PH.D.
• Carol Koch Dempsey
• Dominion Health Medical Assoc
• Elizabeth Engelhorn, LMHC, NCC,

• Rural Health Clinic/Center in Clarksville, VA
• Providers in Clarksville, VA by specialty
• Rural Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.