Mountain Comprehensive Health Corporation
Organization Active NPI Primary Care Clinic/Center · Whitesburg, KY
NPI 1649528845 · NPPES record last updated Oct 7, 2024
Key facts
- NPI
- 1649528845
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
- Practice address
- 435 Cougar Dr
Whitesburg, KY 41858-7009 - Phone
- (606) 633-4823
- Fax
- (606) 633-1874
- NPI assigned
- Aug 17, 2012
- Organization subpart
- No
Authorized official
- Name
- L.M. (Mike) Caudill
- Title
- Ceo
- Phone
- (606) 633-4823
Owners & managing parties with NPI records 1
-
Gary W. Turner, MD
Owned or controlled facilities with NPI records 4
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 34
Practitioners 82
-
Lindsey Adams, APRN-CNP
-
Mahmood Alam, MD
-
Karen Lynn Baker, LPCC-S
-
Nathan W Baker, MD
-
Shana Rae Banks, APRN
-
David Shane Barker, O.D.
-
Lisa Gail Bates, ARNP
-
Brittany Bobrowski, D.O.
-
Audra Boggs, M.ED, LPCC
-
Marye Margaret Campbell Boggs, MD,MPH
-
Matthew Troy Breeding, D.O.
-
Van S Breeding, MD
-
Megan R. Cole, APRN
-
Mary J. Collins, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Federally qualified health center certification: CCN 181898
- Legal name
- MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
- Doing business as
- LETCHER COUNTY CENTRAL HIGH SCHOOL BASED CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 29, 2012
- Last certification
- Dec 29, 2012
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 14, 1972 in KY
- Enrollment address
- 435 Cougar Dr
Whitesburg, KY 41858-7009
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Sherry Childers |
Corporate Director |
Jan 1, 2024 | |
| Amanda Maggard |
Corporate Director |
Jan 1, 2026 | |
| Steve Peake |
Corporate Director |
Jul 20, 2022 | |
| Jerry Hall |
Corporate Director |
Jan 1, 2022 | |
| Mike Caudill |
Corporate Officer |
Jul 1, 2005 | |
| Matilda Parks |
Corporate Director |
Jan 1, 2026 | |
| Gary W Turner |
Corporate Director |
Jan 1, 2026 | |
| David Adams |
Corporate Director |
Jan 1, 2016 | |
| Teresa Dotson |
Corporate Officer |
Sep 8, 2025 | |
| W-2 Managing Employee |
Sep 8, 2025 | ||
| Charles Colwell |
Corporate Director |
Jan 1, 2025 | |
| Gwen Johnson |
Corporate Director |
Jan 1, 2025 | |
| Teresa Hunter |
Corporate Director |
Jan 1, 2025 | |
| Paul Pratt |
Corporate Director |
Jan 1, 2016 | |
| Nanette Banks |
Corporate Director |
Jan 1, 2023 | |
| Robert Musick |
Corporate Director |
Sep 17, 2024 | |
| Carlana G. Mullins |
Corporate Director |
Jan 1, 2013 | |
| Kathy Hall |
Corporate Director |
Jan 1, 2024 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Mountain Comprehensive Health Corporation |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2012 |
| Letcher County Alternative Education School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2012 |
| Mountain Comprehensive Health Corporation |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2012 |
| Mountain Comprehensive Health Corporation |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121229000011 | KY | Part a Provider - Federally Qualified Health Center (FQHC) | 7618875873 | Practice locations: Whitesburg, KY |
National Provider Directory
- Tax ID family
- MTN Comp Health Corp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Primary Care Clinic/Center | 261QP2300X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Primary Care Nurse Practitioner |
363LP2300X |
Addresses
Primary practice location
435 Cougar Dr
Whitesburg, KY 41858-7009
Mailing address
PO Box 40
Whitesburg, KY 41858-0040
Phone (606) 633-4823
Other providers in Whitesburg, KY
- Mountain Comprehensive Health Corporation
- Mountain Comprehensive Health Corporation
- Mountain Comprehensive Health Corporation
- Mountain Comprehensive Health Corporation
- Mountain Comprehensive Health Corporation
- Mountain Comprehensive Health Corporation
- Mountain Comprehensive Health Corporation
- Mountain Comprehensive Health Corporation
- Mountain Heart Center, PSC
- Mountain Instant Care PLLC
All providers in Whitesburg, KY · Primary Care Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.