NPIMap

Organization Active NPI

Community Health Centers of Western Kentucky Inc

  • Federally Qualified Health Center (FQHC)
  • Greenville, KY
National Provider Identifier
1649824426
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC
Practice address
504 Hopkinsville St
Greenville, KY 42345-1104
Phone
(270) 338-6488
Fax
(270) 338-7868
NPI assigned
Jul 30, 2019
Last updated
Dec 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Authorized official

Name
Joseph Allen Swab
Title
Cfo
Phone
(270) 338-5777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

504 Hopkinsville St
Greenville, KY 42345-1104

Mailing address

480 Hopkinsville St
Greenville, KY 42345-1124
Phone (270) 338-5777

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address admin@chcwk270.e-mdsdirect.com
Direct Messaging Address admin@chcwk270.e-mdsdirect.com

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050617000877 KY Part B Supplier - Clinic/Group Practice 5193769370 Receives reassigned benefits from 28 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, KY; Russellville, KY; Guthrie, KY
O20150424001908 KY Part A Provider - Federally Qualified Health Center (FQHC) 5193769370 1 other NPI on this enrollment
Practice locations: Greenville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649824426. Details of each certification follow.

Federally qualified health center certification: CCN 181930

Legal name
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 27, 2015
Last certification
Apr 27, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 1994 in KY
Enrollment address
504 Hopkinsville St
Greenville, KY 42345-1104

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 5

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
18D2083069Community Health Centers of Western Kentucky504 Hopkinsville St, Greenville, KY 42345Certificate of waiverAug 26, 2026

National Provider Directory

National Provider Directory
Tax ID family
Community Health Centers of Western Kentucky Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Interoperability endpoints

  • Direct secure messaging: admin@chcwk270.e-mdsdirect.com

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Cary Davis Individual Corporate DirectorBoard Member Mar 1, 2012
Cindy Baird Individual Corporate DirectorBoard Member Mar 1, 2012
Penelophie J Skipworth Individual W-2 Managing EmployeeBilling Coordinator Dec 26, 2017
Billy Steele Individual Corporate DirectorBoard Member Mar 1, 2012
Richard Neathamer Individual Corporate DirectorBoard Member Mar 1, 2012
Jimmy Owens Individual Corporate DirectorBoard Member Oct 23, 2019
Amanda Henson Individual Corporate DirectorBoard Member Mar 27, 2019
Andrehia Hatfield Individual Corporate DirectorBoard Member Mar 1, 2012
Lindsay B Durall Individual Corporate OfficerCfo Feb 1, 2021
Elizabeth Gentry Individual Corporate DirectorBoard Member Mar 1, 2012
Elizabeth Eaves Individual Corporate DirectorBoard Member Mar 1, 2012

Practitioners & affiliated clinicians

Practitioners 7

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": "1564444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1649824426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 HOPKINSVILLE ST",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451124",
            "telephone_number": "270-338-5777",
            "fax_number": "270-338-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 HOPKINSVILLE ST",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451104",
            "telephone_number": "270-338-6488",
            "fax_number": "270-338-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "SWAB",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "270-338-5777"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "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": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@chcwk270.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "504 Hopkinsville St",
            "city": "Greenville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423451104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@chcwk270.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "504 Hopkinsville St",
            "city": "Greenville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423451104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, KY

Sources for this page

Verify at the official NPI Registry.