NPIMap

Organization Active NPI

Buchanan General Hospital Inc

Doing business as Mountain View Medical Clinic

  • Rural Health Clinic/Center
  • Grundy, VA
National Provider Identifier
1891402228
Registry record updated Nov 4, 2022
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
Mountain View Medical Clinic
Practice address
1520 Slate Creek Rd Ste 204
Grundy, VA 24614-6975
Phone
(276) 935-1385
NPI assigned
Nov 4, 2022
Last updated
Nov 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

1520 Slate Creek Rd Ste 204
Grundy, VA 24614-6975

Mailing address

1520 Slate Creek Rd Ste 204
Grundy, VA 24614-6975
Phone (276) 935-1385

Other names 1

  • Mountain View Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230329003391 VA Part A Provider - Rural Health Clinic 4688581663 Practice locations: Grundy, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891402228. Details of each certification follow.

Rural health clinic certification: CCN 493468

Legal name
BUCHANAN GENERAL HOSPITAL INC.
Doing business as
MOUNTAIN VIEW MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 13, 2023
Last certification
Dec 13, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Feb 25, 1971 in VA
Enrollment address
1520 Slate Creek Rd
Ste 204
Grundy, VA 24614-6975
Related CCNs
490127

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

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.

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Harold Musick Individual Corporate Director Oct 13, 2013
Danny Elswick Individual Corporate Director Apr 6, 2004
Mary Ruth Spencer Individual Corporate Director Dec 1, 2009
Tommy Roger Coleman Individual Corporate Director Jan 1, 2011
Willis Smith Individual Corporate Director Jan 1, 2012
David W Tolliver Individual Corporate Director Sep 1, 2011
Robert Ruchti Individual Corporate Director Dec 28, 2011
W-2 Managing EmployeeCeo Dec 28, 2011
James Wayne Childress Individual Corporate Director Jan 1, 2010
Bradley D Vandyke Individual Corporate Director Feb 28, 2019

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1891402228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 SLATE CREEK RD STE 204",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246146975",
            "telephone_number": "276-935-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SLATE CREEK RD STE 204",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246146975",
            "telephone_number": "276-935-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCHANAN GENERAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-02",
        "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": "Mountain View Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grundy, VA

Sources for this page

Verify at the official NPI Registry.