NPIMap

Organization Active NPI

Clinch Valley Physicians Associates LLC

Doing business as Clinch Valley Physicians

  • Rural Health Clinic/Center
  • Cedar Bluff, VA
National Provider Identifier
1821339540
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CLINCH VALLEY PHYSICIANS ASSOCIATES LLC
Doing business as
Clinch Valley Physicians
Practice address
398 Clinic Rd
Cedar Bluff, VA 24609-9413
Phone
(276) 964-6771
Fax
(276) 964-1314
NPI assigned
Mar 5, 2013
Last updated
Aug 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

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

Addresses

Primary practice location

398 Clinic Rd
Cedar Bluff, VA 24609-9413

Mailing address

1 Clinic Dr
Claypool Hill
Richlands, VA 24641-1102
Phone (276) 964-6771

Other names 1

  • CLINCH VALLEY PHYSICIANS Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130821001053 VA Part B Supplier - Clinic/Group Practice 9133146111 Receives reassigned benefits from 50 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cedar Bluff, VA
O20140624000627 VA Part A Provider - Rural Health Clinic 9133146111 Practice locations: Cedar Bluff, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821339540. Details of each certification follow.

Rural health clinic certification: CCN 493820

Legal name
CLINCH VALLEY PHYSICIANS ASSOCIATES LLC
Doing business as
CLINCH VALLEY PHYSICIANS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 4, 1994
Last certification
Jul 21, 2025
Ownership / control type
1B
Most recent change of ownership
Jul 2, 2013 (1 total)
Organization structure
LLCProprietary
Incorporated
Jul 8, 2005 in VA
Enrollment address
398 Clinic Rd
Cedar Bluff, VA 24609-9413

Other NPIs with the same Medicare PAC ID 1

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.

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
49D0233388Clinch Valley Physicians Associates, LLC398 Clinic Road, Cedar Bluff, VA 24609ComplianceFeb 23, 2027
49D1027328Clinch Valley Physicians Associates, LLC398 Clinic Road, Cedar Bluff, VA 24609Provider-performed microscopyJun 27, 2028
49D1034440Clinch Valley Physicians Associates, LLC398 Clinic Road, Cedar Bluff, VA 24609Certificate of waiverDec 1, 2026
49D2124812Clinch Valley Physicians Associates, LLC398 Clinic Road, Cedar Bluff, VA 24609Certificate of waiverJan 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Clinch Valley Endocrinology LLC4 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 11

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

NameRoleSinceShare
Pamela Kane Individual Corporate OfficerVice President Aug 9, 2022
DSB Acquisition LLC Organization, New York, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Laura C Hinson Individual Corporate OfficerChief Financial Officer Mar 12, 2025
Lifepoint Health Inc Organization, Brentwood, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Charlotte E Lawrence Individual Corporate OfficerSecretary Jan 21, 2022
Elliott Brown Individual Corporate OfficerSenior Vice President and Treasu Apr 2, 2026
Lifepoint Acquisition Corp Organization, Brentwood, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2013 100%
Klaus Michael Boel Individual Corporate OfficerPresident Aug 19, 2024
W-2 Managing Employee Aug 19, 2024
Christopher J Monte Individual Corporate OfficerVice President Jul 2, 2013 100%
Lifepoint VA Holdings Inc Organization, Brentwood, TN Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Jul 2, 2013 100%
Legacy Lifepoint Health LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%

Facilities with the same owner 193

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 193

Practitioners & affiliated clinicians

Practitioners 50

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 50

NPI Registry JSON

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1821339540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CLINIC DR",
            "address_2": "CLAYPOOL HILL",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246411102",
            "telephone_number": "276-964-6771",
            "fax_number": "276-964-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 CLINIC RD",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246099413",
            "telephone_number": "276-964-6771",
            "fax_number": "276-964-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINCH VALLEY PHYSICIANS ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-05",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINCH VALLEY PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CLINCH VALLEY PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Bluff, VA

Sources for this page

Verify at the official NPI Registry.