NPIMap

Organization Active NPI

East Ky Health Service Center

  • Federally Qualified Health Center (FQHC)
  • Hindman, KY
National Provider Identifier
1538736129
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EAST KY HEALTH SERVICE CENTER
Practice address
566 Highway 899 # 849
Hindman, KY 41822-8955
Phone
(606) 785-3164
Fax
(606) 785-0107
NPI assigned
Jun 10, 2021
Last updated
Oct 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Authorized official

Name
Dr. Benny Ray Bailey, PH.D
Title
Executive Dir / Ceo
Phone
(606) 785-3164

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

566 Highway 899 # 849
Hindman, KY 41822-8955

Mailing address

PO Box 849
Hindman, KY 41822-0849
Phone (606) 785-3164

Other identifiers 1

IdentifierTypeStateIssuer
7100798320MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141124001774 KY Part A Provider - Rural Health Clinic 6901844711 Practice locations: Hindman, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538736129. Details of each certification follow.

Rural health clinic certification: CCN B03853

Legal name
EAST KY HEALTH SERVICE CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 30, 2021
Last certification
Nov 30, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1972 in KY
Enrollment address
566 Highway 899
Hindman, KY 41822-8955

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
East Ky Health Service Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Warren G Stumbo Individual Corporate OfficerPresident Jan 1, 2013
Corporate DirectorBoard Member Jan 1, 2013
W-2 Managing EmployeeMedical Director Jan 1, 2013
Benny Bailey Individual Corporate OfficerVice President Jan 1, 2013
Corporate DirectorBoard Member Jan 1, 2013
W-2 Managing EmployeeExecutive Director Jan 1, 2013
Lavonna M Bailey Individual Corporate OfficerChief Operations Officer Jan 1, 2013
Operational/Managerial ControlOperations Officer Jan 1, 2013

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 3

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": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791158400000",
    "number": "1538736129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849",
            "city": "HINDMAN",
            "state": "KY",
            "postal_code": "418220849",
            "telephone_number": "606-785-3164",
            "fax_number": "606-785-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 HIGHWAY 899 # 849",
            "city": "HINDMAN",
            "state": "KY",
            "postal_code": "418228955",
            "telephone_number": "606-785-3164",
            "fax_number": "606-785-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST KY HEALTH SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "BENNY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "EXECUTIVE DIR / CEO",
        "authorized_official_telephone_number": "606-785-3164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100798320",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hindman, KY

Sources for this page

Verify at the official NPI Registry.