Grace Community Health Center Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GRACE COMMUNITY HEALTH CENTER INC

Doing business as

Flat Lick Elementary School Based Health Clinic

Practice address

110 Ky 3085
Flat Lick, KY 40935-6461

Phone

(606) 543-4712

NPI assigned

Dec 5, 2017

Last updated

Jun 28, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

GRACE COMMUNITY HEALTH CENTER INCAs reported in NPPES

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

Authorized official

Name

Chad Stevens

Title

Authorized Official

Phone

(606) 526-9005

Specialties & licenses 1

Addresses

Other names 1

• Flat Lick Elementary School Based Health Clinic Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629583232. Details of each certification follow.

• CCN 181069 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 181069

Legal name

FLAT LICK ELEMENTARY SCHOOL BASED HEALTH CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 23, 2018

Last certification

Feb 23, 2018

Ownership / control type

For profit – corporation

Facility address

110 Ky 3085
Flat Lick, KY 40935

Part of

Grace Community Health Center Inc

Locations

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1629583232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 CUMBERLAND FALLS HWY STE B201",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012793",
            "telephone_number": "606-526-9005",
            "fax_number": "606-526-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 KY 3085",
            "city": "FLAT LICK",
            "state": "KY",
            "postal_code": "409356461",
            "telephone_number": "606-543-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRACE COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2017-12-05",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "606-526-9005"
    },
    "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": "Flat Lick Elementary School Based Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Chandler Physical Therapy
• Barbara A Chandler, P.T.
• Flat Lick Medical Clinic PLLC
• Grace Community Health Center Inc (Dewitt Elementary School Based Health Clinic)

• Federally Qualified Health Center (FQHC) in Flat Lick, KY
• Providers in Flat Lick, KY by specialty
• Federally Qualified Health Center (FQHC) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.