NPIMap

Organization Active NPI

Regional Health Care Affiliates Inc

  • Federally Qualified Health Center (FQHC)
  • Clay, KY
National Provider Identifier
1679395040
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
REGIONAL HEALTH CARE AFFILIATES INC
Practice address
140 Veterans Memorial Ave
Clay, KY 42404
Phone
(270) 664-2526
Fax
(270) 664-6082
NPI assigned
Oct 28, 2024
Last updated
Jul 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Authorized official

Name
Shelley Gobin
Title
Auth Official
Phone
(270) 667-7017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

140 Veterans Memorial Ave
Clay, KY 42404

Mailing address

140 Veterans Memorial Ave
Clay, KY 42404
Phone (270) 664-2526

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250428003660 KY Part A Provider - Federally Qualified Health Center (FQHC) 3173668274 Practice locations: Clay, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679395040. Details of each certification follow.

Federally qualified health center certification: CCN B01183

Legal name
REGIONAL HEALTH CARE AFFILIATES, INC
Doing business as
HEALTH FIRST COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 16, 2025
Last certification
Apr 16, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
140 Veterans Memorial Ave
Clay, KY 42404-2110

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Regional Health Care Affiliates Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

472 Klutey Park Plaza Dr
#B
Henderson, KY 42420
Phone (270) 856-5522

220 N Morgan St
Morganfield, KY 42437
Phone (270) 285-1318

121 E Main St
Providence, KY 42450
Phone (270) 667-2023

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Pat Green Individual Other Feb 20, 2025
Amanda Dame Individual Other Feb 20, 2025
Shelley Gobin Individual Corporate OfficerCeo Feb 20, 2025
W-2 Managing EmployeeAd;Ceo Feb 20, 2025
Ali Drake Individual Other Feb 20, 2025
Shannon Layton Individual Other Feb 20, 2025
Venita Murphy Individual Other Feb 20, 2025
Anthony Dotson Individual Other Feb 20, 2025
Raegina Scott Individual OtherBoard Member Feb 20, 2025

Practitioners & affiliated clinicians

Practitioners 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1679395040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 VETERANS MEMORIAL AVE",
            "city": "CLAY",
            "state": "KY",
            "postal_code": "42404",
            "telephone_number": "270-664-2526",
            "fax_number": "270-664-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 VETERANS MEMORIAL AVE",
            "city": "CLAY",
            "state": "KY",
            "postal_code": "42404",
            "telephone_number": "270-664-2526",
            "fax_number": "270-664-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL HEALTH CARE AFFILIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "GOBIN",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "AUTH OFFICIAL",
        "authorized_official_telephone_number": "270-667-7017"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clay, KY

Sources for this page

Verify at the official NPI Registry.