NPIMap

Organization Active NPI

Tri Area Community Health

Doing business as Tri Area Community Health at Carroll County Schools

  • Federally Qualified Health Center (FQHC)
  • Hillsville, VA
National Provider Identifier
1942040464
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TRI AREA COMMUNITY HEALTH
Doing business as
Tri Area Community Health at Carroll County Schools
Practice address
100 Cavs LN
Hillsville, VA 24343-1669
Phone
(888) 908-4788
Fax
(276) 398-3331
NPI assigned
May 31, 2024
Last updated
May 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Authorized official

Name
Carol Hash
Title
Accounts Receivable Manager
Phone
(276) 398-1200

Specialties & licenses 1

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

Addresses

Primary practice location

100 Cavs LN
Hillsville, VA 24343-1669

Mailing address

PO Box 9
Laurel Fork, VA 24352-0009
Phone (276) 398-1200

Other names 1

  • Tri Area Community Health at Carroll County Schools Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040122000969 VA Part B Supplier - Clinic/Group Practice 6204748296 Receives reassigned benefits from 46 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Independence, VA; Troutdale, VA; Stuart, VA; Laurel Fork, VA; Hillsville, VA; Galax, VA; Fries, VA; Floyd, VA…
O20241003003967 VA Part A Provider - Federally Qualified Health Center (FQHC) 6204748296 Practice locations: Hillsville, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942040464. Details of each certification follow.

Federally qualified health center certification: CCN 491029

Legal name
TRI AREA COMMUNITY HEALTH
Doing business as
TRI AREA COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 5, 2024
Last certification
Jul 5, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 31, 1980 in VA
Enrollment address
100 Cavs LN
Hillsville, VA 24343-1669

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Tri Area Health Clinic15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

140 Christiansburg Pike NE
Floyd, VA 24091
Phone (540) 745-9290

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Delia Heck Individual Corporate Director Jan 1, 2017
Laura Beth Parnell Individual Corporate Director Sep 27, 2022
James L Werth Individual Corporate Officer Jun 24, 2019
W-2 Managing Employee Jun 24, 2019
Willaim Shepley Individual Corporate Director Jan 1, 2021
Sonita Harris Individual Corporate Director Feb 1, 2024
David Hernandez Individual Corporate Director Apr 1, 2024
Brenda Hopkins Individual Corporate Director Jan 1, 2017
Jana Pobrislo Individual Corporate Director Feb 1, 2024
Kathleen Anderson Individual Corporate Director Mar 28, 2023
Kayla a Boyd Individual Corporate Officer Dec 1, 2015
W-2 Managing Employee Dec 1, 2015
Donna Garrison Individual Corporate Director Jan 25, 2022
Stevens Terry Individual Corporate Director Sep 27, 2023
Chip Phillips Individual Corporate Director Jan 1, 2013
Brenda Sutherland Individual Corporate Director Feb 22, 2022

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tri Area Community HealthFries, VA, CCN 491010 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 7, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 9

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": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1942040464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "LAUREL FORK",
            "state": "VA",
            "postal_code": "243520009",
            "telephone_number": "276-398-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAVS LN",
            "city": "HILLSVILLE",
            "state": "VA",
            "postal_code": "243431669",
            "telephone_number": "888-908-4788",
            "fax_number": "276-398-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI AREA COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "HASH",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE MANAGER",
        "authorized_official_telephone_number": "276-398-1200"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri Area Community Health at Carroll County Schools",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hillsville, VA

Sources for this page

Verify at the official NPI Registry.