NPIMap

Organization Active NPI

Community Health Clinic, PC

  • Clinical Medical Laboratory
  • Honaker, VA
National Provider Identifier
1669674685
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 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
Last updated
May 6, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CLINIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Kim Blankenship
Title
Data Processing
Phone
(276) 873-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

5705 Redbud Hwy
Honaker, VA 24260

Mailing address

PO Box 1020
Honaker, VA 24260-1020
Phone (276) 873-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040825000081 VA Part B Supplier - Clinic/Group Practice 5890769863 Receives reassigned benefits from 10 practitioners
Practice locations: Richlands, VA; Honaker, VA; Chantilly, VA

Other NPIs with the same Medicare PAC ID 1

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

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
49D0933746Community Health Clinic PC5705 Redbud Hwy, Honaker, VA 24260ComplianceAug 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Community Health Clinic PC2 organizations share this tax ID, including this one
Part of
Community Health Clinic PC

Other organizations with this tax ID 1

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

Locations

1957 2nd St
Richlands, VA 24641
Phone (276) 873-6300

Practitioners & affiliated clinicians

Practitioners 10

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": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1669674685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1020",
            "city": "HONAKER",
            "state": "VA",
            "postal_code": "242601020",
            "telephone_number": "276-873-6300",
            "fax_number": "276-873-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 REDBUD HWY",
            "city": "HONAKER",
            "state": "VA",
            "postal_code": "24260",
            "telephone_number": "276-873-6300",
            "fax_number": "276-873-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CLINIC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CLINIC, PC",
        "enumeration_date": "2007-06-01",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "DATA PROCESSING",
        "authorized_official_telephone_number": "276-873-6300"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honaker, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.