NPIMap

Organization Active NPI

Martinsville Henry County Coalition for Health and Wellness

Doing business as Ridgeway Family Health

  • Federally Qualified Health Center (FQHC)
  • Ridgeway, VA
National Provider Identifier
1689182164
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
Doing business as
Ridgeway Family Health
Practice address
4944 Greensboro Rd
Ridgeway, VA 24148-3390
Phone
(276) 638-0787
Fax
(276) 956-1629
NPI assigned
Jan 18, 2018
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Gina Finocchiaro
Title
Chief Financial Officer
Phone
(276) 403-5096

Specialties & licenses 1

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

Addresses

Primary practice location

4944 Greensboro Rd
Ridgeway, VA 24148-3390

Mailing address

4944 Greensboro Rd
Ridgeway, VA 24148-3390
Phone (276) 638-0787

Other names 1

  • Ridgeway Family Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080721000741 VA Part B Supplier - Clinic/Group Practice 4385717552 Receives reassigned benefits from 21 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bassett, VA; Martinsville, VA; Ridgeway, VA; Stuart, VA
O20180503002402 VA Part A Provider - Federally Qualified Health Center (FQHC) 4385717552 Practice locations: Ridgeway, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689182164. Details of each certification follow.

Federally qualified health center certification: CCN 491962

Legal name
MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
Doing business as
RIDGEWAY FAMILY HEALTH
Organization structure
CorporationNon-profit
Incorporated
Apr 4, 2005 in VA
Enrollment address
4944 Greensboro Rd
Ridgeway, VA 24148-3390

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 3

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
49D2136905Ridgeway Family Health4944 Greensboro Road, Ridgeway, VA 24148Provider-performed microscopySep 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Martinsville Henry County Coalition for Health and Wellness4 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.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Charlotte Harter Individual Corporate Director Dec 1, 2017
Edna Ekuban-Gordon Individual W-2 Managing Employee Nov 5, 2021
Deshanta Hairston Individual Corporate Director Jan 1, 2021
Charles Graves Anthony Individual Corporate Director Jan 1, 2024
Harry Scott Martin Individual Corporate Director Aug 1, 2015
Lacoma Hairston Individual Corporate Director May 28, 2019
William M Stone Individual Corporate DirectorCeo Mar 1, 2021
W-2 Managing EmployeeCeo Mar 1, 2021
Operational/Managerial ControlCeo Mar 1, 2021
Ralph Lawson Individual Corporate Director Mar 1, 2012
Ron Hairston Individual Corporate Director Aug 1, 2014
Lisa Rivera Individual Corporate Director May 22, 2018
Victor Millner Individual Corporate DirectorMember Dec 1, 2014
Kenneth Muse Individual Corporate Director Jul 1, 2010
Ardys Winslow Individual Corporate Director Jan 22, 2019
Brandon Martin Individual Corporate Director Jan 1, 2021
Gina D Finocchiaro Individual W-2 Managing EmployeeCfo Oct 15, 2021
Operational/Managerial ControlCfo Oct 15, 2021
Darrin Doss Individual Corporate Director Jan 1, 2021
Linda Dorr Individual Corporate DirectorSecretary Aug 1, 2014

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Connect Health + WellnessMartinsville, VA, CCN 491013 Federally qualified health center Operational/Managerial Control (100%) Oct 15, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1689182164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4944 GREENSBORO RD",
            "city": "RIDGEWAY",
            "state": "VA",
            "postal_code": "241483390",
            "telephone_number": "276-638-0787",
            "fax_number": "276-956-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4944 GREENSBORO RD",
            "city": "RIDGEWAY",
            "state": "VA",
            "postal_code": "241483390",
            "telephone_number": "276-638-0787",
            "fax_number": "276-956-1629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "FINOCCHIARO",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "276-403-5096"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgeway Family Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgeway, VA

Sources for this page

Verify at the official NPI Registry.