NPIMap

Organization Active NPI

Big Sandy Health Care Inc

Doing business as Shelby Valley Clinic

  • Federally Qualified Health Center (FQHC)
  • Pikeville, KY
National Provider Identifier
1700828597
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
700058 Issued in KY
Legal business name
BIG SANDY HEALTH CARE INC
Doing business as
Shelby Valley Clinic
Practice address
178 Douglas Pkwy
Shelby Valley Clinic
Pikeville, KY 41501-6970
Phone
(606) 639-3135
Fax
(888) 854-5336
NPI assigned
Jun 13, 2006
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Mr. James Herald
Title
Ceo
Phone
(606) 886-8546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 700058 KY Primary

Addresses

Primary practice location

178 Douglas Pkwy
Shelby Valley Clinic
Pikeville, KY 41501-6970

Mailing address

1709 Ky Route 321
Suite 3 Big Sandy Health Care Inc
Prestonsburg, KY 41653-9101
Phone (606) 886-8546

Other identifiers 1

IdentifierTypeStateIssuer
31000417MedicaidKY

Other names 1

  • Shelby Valley Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040510000841 KY Part B Supplier - Clinic/Group Practice 1951211218 Receives reassigned benefits from 72 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hi Hat, KY; Warfield, KY; Salyersville, KY; Pikeville, KY; Inez, KY; Harold, KY; Grethel, KY; Eastern, KY…
O20100917000693 KY Part A Provider - Federally Qualified Health Center (FQHC) 1951211218 Practice locations: Pikeville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700828597. Details of each certification follow.

Federally qualified health center certification: CCN 181828

Legal name
BIG SANDY HEALTH CARE, INC
Doing business as
SHELBY VALLEY CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 23, 1994
Last certification
Nov 23, 1994
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 20, 1974 in KY
Enrollment address
178 Douglas Parkway
Pikeville, KY 41501-6970
Related CCNs
181819

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Vicki Deskins Individual Corporate DirectorBoard Member Jul 25, 2022
James Herald Individual Corporate OfficerChief Executive Officer Nov 15, 2024
Gregory Napier Individual Corporate DirectorBoard Member Jun 27, 2022
Martha N Ellis Individual Corporate DirectorBoard Member Feb 26, 2024
Roy Conley Individual Corporate DirectorBoard Member Aug 26, 2006
Amy Smith Individual Corporate Director Sep 23, 2019
Bobby Hale Individual Corporate DirectorBoard Member Jun 22, 2009
Kathy Hembree Individual Corporate DirectorBoard Member Oct 9, 1989
Thomas Callahan Individual Corporate DirectorBoard Member Jan 22, 2024
Kathy Trimble Individual Corporate DirectorBoard Member Jul 24, 2006
Melissa Turner Individual Corporate Director Jul 27, 2015
Tina Terry Individual Corporate DirectorBoard Member Sep 26, 2011
Summer Morris Individual Corporate OfficerChief Financial Officer Nov 1, 2022
Joann Arnett Individual Corporate DirectorBoard Member Nov 1, 1988
Kimberly Daniels Individual Corporate DirectorBoard Member Feb 26, 2024
Mary McMasters Individual Corporate DirectorBoard Member Feb 27, 2012
Surekha Maddiwar Individual Corporate DirectorBoard Member Jan 18, 1993
James O'Bryan Individual Corporate DirectorBoard Member Jan 22, 2024
Linda Martin Individual Corporate DirectorBoard Member Jun 27, 2022
Michael Shoemaker Individual Corporate DirectorBoard Member Apr 27, 2009
Debbie Colvin Individual W-2 Managing EmployeeCredentialing Manager Nov 29, 2021
Wilbur Lindsey Individual Corporate Director May 20, 2018
Mike Prater Individual Corporate DirectorBoard Member Jan 27, 2003

Practitioners & affiliated clinicians

Practitioners 54

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 54

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1700828597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 KY ROUTE 321",
            "address_2": "SUITE 3 BIG SANDY HEALTH CARE INC",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416539101",
            "telephone_number": "606-886-8546",
            "fax_number": "606-886-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 DOUGLAS PKWY",
            "address_2": "SHELBY VALLEY CLINIC",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415016970",
            "telephone_number": "606-639-3135",
            "fax_number": "888-854-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG SANDY HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "HERALD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-886-8546",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "KY",
            "license": "700058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31000417",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelby Valley Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shelby Valley Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikeville, KY

Sources for this page

Verify at the official NPI Registry.