NPIMap

Organization Active NPI

Regional Health Care Affiliates, Inc.

  • Family Medicine Physician
  • Owensboro, KY
National Provider Identifier
1588058069
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
REGIONAL HEALTH CARE AFFILIATES, INC.
Practice address
2816 Veach Rd
Suite 205
Owensboro, KY 42303-6295
Phone
(270) 926-9821
Fax
(270) 926-9867
NPI assigned
Mar 24, 2015
Last updated
Feb 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Authorized official

Name
Shelley Gobin
Title
Ceo
Phone
(270) 667-7017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2816 Veach Rd
Suite 205
Owensboro, KY 42303-6295

Mailing address

PO Box 37
Providence, KY 42450-0037
Phone (270) 667-7017

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100824000119 KY Part B Supplier - Clinic/Group Practice 3173668274 Receives reassigned benefits from 40 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clay, KY; Providence, KY; Princeton, KY; Owensboro, KY; Morganfield, KY; Henderson, KY; Earlington, KY; Calhoun, KY
O20160620000432 KY Part A Provider - Federally Qualified Health Center (FQHC) 3173668274 Practice locations: Owensboro, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1588058069. Details of each certification follow.

Federally qualified health center certification: CCN 181964

Legal name
REGIONAL HEALTH CARE AFFILIATES, INC
Doing business as
THE NEEL CLINIC HEALTH FIRST
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 2016
Last certification
Jul 1, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 29, 1982 in KY
Enrollment address
2816 Veach Rd
Ste 205
Owensboro, KY 42303-6299

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0326281Neel Clinic Health First, the2816 Veach Road, Suite 205, Owensboro, KY 42303Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Regional Health Care Affiliates Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

2816 Veach Rd
Ste 205
Owensboro, KY 42303
Phone (270) 926-9821

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Myra Braden Individual Corporate DirectorBoard Member Jan 1, 2015
Shelley Gobin Individual Corporate OfficerInterim Ceo Jan 1, 2018
W-2 Managing Employee Jan 1, 2018
Vanessa Torres Individual Corporate DirectorBoard Member Jan 1, 2015
Sharon Steedley Individual Corporate DirectorBoard Member Jan 1, 2015
Anthony Dotson Individual Corporate DirectorBoard Member Jan 1, 2015
Monte D Davenport Individual Corporate DirectorBoard Member Jan 1, 2015
Allen Rudd Individual Corporate DirectorBoard Member Jan 1, 2015

Practitioners & affiliated clinicians

Practitioners 4

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": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1588058069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "PROVIDENCE",
            "state": "KY",
            "postal_code": "424500037",
            "telephone_number": "270-667-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 VEACH RD",
            "address_2": "SUITE 205",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423036295",
            "telephone_number": "270-926-9821",
            "fax_number": "270-926-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL HEALTH CARE AFFILIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "GOBIN",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-667-7017"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.