Community Health Clinic, PC
Organization Active NPI Clinical Medical Laboratory · Honaker, VA
NPI 1669674685 · NPPES record last updated May 6, 2009
Key facts
- NPI
- 1669674685
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- COMMUNITY HEALTH CLINIC, PC
- Practice address
- 5705 Redbud Hwy
Honaker, VA 24260 - Phone
- (276) 873-6300
- Fax
- (276) 873-5859
- NPI assigned
- Jun 1, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- COMMUNITY HEALTH CLINIC, PC
Authorized official
- Name
- Kim Blankenship
- Title
- Data Processing
- Phone
- (276) 873-6300
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 10
-
Crystal Ball, FNP-C
-
Retha Michelle Blevins, FNP-C
-
Muna Faisal Chaudhry, M.D.
-
Jessica Dawn Jennings, NP-C
-
Tammy Lynn Whitt, RN, APRN, FNP-BC
-
Angela M Lundy, NP
-
Amy Nicole Shortt, ACNP-AG
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D0933746 | Community Health Clinic PC | Compliance | Aug 31, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040825000081 | VA | Part B Supplier - Clinic/Group Practice | 5890769863 |
Receives reassigned benefits from 10 practitioners Practice locations: Richlands, VA; Honaker, VA; Chantilly, VA |
National Provider Directory
- Tax ID family
- Community Health Clinic PC
- Part of
- Community Health Clinic PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
5705 Redbud Hwy
Honaker, VA 24260
Mailing address
PO Box 1020
Honaker, VA 24260-1020
Phone (276) 873-6300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 282424 | Other | VA | BC/BS |
| CK2829 | Other | VA | RAILROAD MEDICARE |
Other providers in Honaker, VA
- Barnhart Chiropractic & Wellness PLC
- Eric K Barnhart
- Rebecca K Cantrell
- Faisal W Chaudhry
- Community Health Clinic PC
- Lori Dye
- Family Preservation Services, Inc
- Nicholas Harmon
- Daniel Furl Hess
- Sarah McGlothlin
All providers in Honaker, VA · Clinical Medical Laboratory in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2009. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.