NPIMap

Organization Active NPI

Buchanan General Hospital Inc

Doing business as Commonwealth Family Clinic

  • Rural Health Clinic/Center
  • Grundy, VA
National Provider Identifier
1740873009
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BUCHANAN GENERAL HOSPITAL INC
Doing business as
Commonwealth Family Clinic
Practice address
1532 Slate Creek Rd Ste 105
Grundy, VA 24614-6975
Phone
(276) 935-1760
NPI assigned
Feb 18, 2021
Last updated
Mar 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Authorized official

Name
Kimetha Lea Boyd
Title
Chief Financial Officer
Phone
(276) 935-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1532 Slate Creek Rd Ste 105
Grundy, VA 24614-6975

Mailing address

1535 Slate Creek Rd
Grundy, VA 24614-6974
Phone (276) 935-1000

Other names 1

  • Commonwealth Family Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210928002375 VA Part A Provider - Other 4688581663 Practice locations: Grundy, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740873009. Details of each certification follow.

Rural health clinic certification: CCN 493467

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMONWEALTH FAMILY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 3, 2023
Last certification
Oct 3, 2023
Ownership / control type
2B
Facility address
1532 Slate Creek Rd, Suite 105
Grundy, VA 24614
Related CCNs
490127

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Mathew Scaria MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

1532 Slate Creek Rd
Grundy, VA 24614
Phone (276) 935-2080

Practitioners & affiliated clinicians

Practitioners 6

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": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1740873009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 SLATE CREEK RD",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246146974",
            "telephone_number": "276-935-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 SLATE CREEK RD STE 105",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246146975",
            "telephone_number": "276-935-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCHANAN GENERAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "KIMETHA",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "276-935-1111"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grundy, VA

Sources for this page

Verify at the official NPI Registry.