NPIMap

Organization Active NPI

Bluestone Health Association, Inc.

Doing business as Bluestone Family Practice

  • Federally Qualified Health Center (FQHC)
  • Bluefield, WV
National Provider Identifier
1770950396
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BLUESTONE HEALTH ASSOCIATION, INC.
Doing business as
Bluestone Family Practice
Practice address
701 Bland St
Bluefield, WV 24701-3503
Phone
(304) 800-5413
Fax
(304) 325-5803
NPI assigned
Aug 31, 2015
Last updated
Jul 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BLUESTONE HEALTH ASSOCIATION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Linda Hutchens
Title
Ceo
Phone
(304) 431-5499

Specialties & licenses 1

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

Addresses

Primary practice location

701 Bland St
Bluefield, WV 24701-3503

Mailing address

3997 Beckley Rd
Princeton, WV 24740-7660
Phone (304) 431-5499

Other names 1

  • Bluestone Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151021003313 WV Part A Provider - Federally Qualified Health Center (FQHC) 3577505221 Practice locations: Bluefield, WV
O20160426000491 WV Part B Supplier - Clinic/Group Practice 3577505221 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
Practice locations: Bluefield, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770950396. Details of each certification follow.

Federally qualified health center certification: CCN 511077

Legal name
BLUESTONE HEALTH ASSOCIATION, INC.
Doing business as
BLUESTONE FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 8, 2015
Last certification
Sep 8, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 26, 1976 in WV
Enrollment address
701 Bland St
Bluefield, WV 24701-3503

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Bluestone Health Associ

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Janet G Shrewsbury Individual OtherBoard Member Sep 26, 2022
Charles Wolfe Individual OtherBoard Member May 1, 2024
Nathan Hendrick Individual OtherBoard Member May 1, 2024
Norman Fletcher Individual OtherBoard Member Jan 1, 1995
Norma Clark Individual OtherBoard Member Jan 1, 2010
Carmen Hendrick Individual OtherBoard Member May 1, 2024
Brittani Hutchens Individual Corporate DirectorChief Executive Officer May 31, 2024
W-2 Managing EmployeeAd; May 31, 2024
Kurt Rice Individual OtherBoard Member Sep 1, 2021
Marsha Howell Individual OtherBoard Member Jan 1, 1986
Mary Joann Dixon Individual Corporate OfficerBoard Member Nov 30, 2020
Melanie Jessee Individual OtherBoard Member Oct 22, 2012

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1770950396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3997 BECKLEY RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247407660",
            "telephone_number": "304-431-5499",
            "fax_number": "304-431-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BLAND ST",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247013503",
            "telephone_number": "304-800-5413",
            "fax_number": "304-325-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUESTONE HEALTH ASSOCIATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUESTONE HEALTH ASSOCIATION, INC.",
        "enumeration_date": "2015-08-31",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "HUTCHENS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-431-5499"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluestone Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bluestone Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bluefield, WV

Sources for this page

Verify at the official NPI Registry.