NPIMap

Organization Active NPI

Mountain Comprehensive Health Corporation

  • Primary Care Clinic/Center
  • Whitesburg, KY
National Provider Identifier
1902980865
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
700017 Issued in KY
Legal business name
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Practice address
226 Medical Plaza LN
Whitesburg, KY 41858-7425
Phone
(606) 633-4823
Fax
(606) 633-1874
NPI assigned
Oct 25, 2006
Last updated
Oct 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
L.M. (Mike) Caudill
Title
Chief Executive Officer
Phone
(606) 633-4823

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Primary Care Clinic/Center 261QP2300X 700017 KY Primary

Addresses

Primary practice location

226 Medical Plaza LN
Whitesburg, KY 41858-7425

Mailing address

PO Box 40
Whitesburg, KY 41858-0040
Phone (606) 633-4823

Other identifiers 1

IdentifierTypeStateIssuer
31000169MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
MTN Comprehensive HLTH35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1902980865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418580040",
            "telephone_number": "606-633-4823",
            "fax_number": "606-633-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 MEDICAL PLAZA LN",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418587425",
            "telephone_number": "606-633-4823",
            "fax_number": "606-633-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN COMPREHENSIVE HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "CAUDILL",
        "authorized_official_first_name": "L.M. (MIKE)",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "606-633-4823"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "700017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31000169",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitesburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.