Clinch River Health Services, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CLINCH RIVER HEALTH SERVICES, INC.

Practice address

17633 Veterans Memorial Hwy
Dungannon, VA 24245-3929

Phone

(276) 467-2201

Fax

(276) 467-2673

NPI assigned

May 20, 2025

Last updated

Jul 24, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

CLINCH RIVER HEALTH SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Gary W Gilliam, FNPNPI 1154704708

Title

Executive Director

Phone

(276) 467-2201

Specialties & licenses 2

Addresses

Tax ID family

Clinch River Health Serv2 organizations share this tax ID, including this one

Part of

Clinch River Health Serv

Other organizations with this tax ID 1

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

• Clinch River Health Services Inc

  dba Clinch River Health Services

  • Federally Qualified Health Center (FQHC)
  • Dungannon, VA
  • NPI 1558653741
  NPD tax ID

Practitioners 1

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.

• Gary Wayne Gilliam, FNP

  • Family Nurse Practitioner
  • Dungannon, VA
  • NPI 1154704708
  Authorized official Same address or phone

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1629860275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17633 VETERANS MEMORIAL HWY",
            "city": "DUNGANNON",
            "state": "VA",
            "postal_code": "242453929",
            "telephone_number": "276-467-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17633 VETERANS MEMORIAL HWY",
            "city": "DUNGANNON",
            "state": "VA",
            "postal_code": "242453929",
            "telephone_number": "276-467-2201",
            "fax_number": "276-467-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINCH RIVER HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLINCH RIVER HEALTH SERVICES, INC.",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "GILLIAM",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "276-467-2201",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Buchanan Pharmacies, Inc. (Clinch River Pharmacy)
• Rachel Owens Burke, FNP
• Todd Cassel, MD
• Clinch River Health Services Inc (Clinch River Health Services)
• Clinch River Health Services, Inc.
• Robert Dockery, PHARMD
• Meagan B Evans
• Family Preservation Services, Inc
• Gary Wayne Gilliam, FNP
• Cassie Marie Gouge, FNP-BC

• Federally Qualified Health Center (FQHC) in Dungannon, VA
• Providers in Dungannon, VA by specialty
• Federally Qualified Health Center (FQHC) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.