MOUNTAIN COMPREHENSIVE HEALTH CORPORATION (NPI# 1063913788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063913788 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN COMPREHENSIVE HEALTH CORPORATION |
| Other Organization Name | MIDDLESBORO CAMPUS CLINIC |
| Practice Address |
1540 Us Highway 25 E Middlesboro KY 40965-1861 |
| Mailing Address |
Po Box 40 Whitesburg KY 41858-0040 |
| Practice Telephone | 6066549450 |
| Mailing Telephone | 6066334823 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2019-08-14 |
| Authorized Official Name | DELENA P MILLER (CREDENTIALING) |
| Authorized Official Telephone | 6066334823 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
700017 | KY | Ambulatory Health Care Facilities |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Middlesboro Campus Clinic | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 College Rd Ste 131-132, Middlesboro, KY 409658303 | 6066549450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598247447 | Mountain Comprehensive Health Corporation | Clinic/Center | 372 Ky 28 Ste A, Booneville, KY 41314-7325 | 2018-09-06 |
| 1316429269 | Mountain Comprehensive Health Corporation | Clinic/Center | 177 Shepherd Rd Ste A, Booneville, KY 41314-7343 | 2018-09-06 |
| 1609358159 | Mountain Comprehensive Health Corporation | Clinic/Center | 401 W Virginia Ave Ste A, Pineville, KY 40977-1321 | 2018-08-31 |
| 1508277831 | Mountain Comprehensive Health Corporation | Physician Assistant | 9165 S Ky Hwy 15, Suite A, Happy, KY 41746 | 2014-05-08 |
| 1881938363 | Mountain Comprehensive Health Corporation | Family Medicine | 269 Highway 3086, Jenkins, KY 41537-9204 | 2012-11-21 |
| 1235473711 | Mountain Comprehensive Health Corporation | Family Medicine | 58 B Ball Park Drive, Mcroberts, KY 41835-9099 | 2012-11-21 |
| 1710235916 | Mountain Comprehensive Health Corporation | Family Medicine | 330 Parks St, Whitesburg, KY 41858-7539 | 2012-08-17 |
| 1649528845 | Mountain Comprehensive Health Corporation | Physician Assistant | 435 Cougar Dr, Whitesburg, KY 41858-7009 | 2012-08-17 |
| 1003164203 | Mountain Comprehensive Health Corporation | Physician Assistant | 185 Circle Dr Ste A, Whitesburg, KY 41858-7662 | 2012-08-17 |
| 1679821995 | Mountain Comprehensive Health Corporation | Family Medicine | 162 Lhs Drive, Letcher, KY 41832 | 2012-08-16 |
| Street Address |
1540 US HIGHWAY 25 E |
| City | MIDDLESBORO |
| State | KY |
| Zip Code | 40965-1861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387064 | Christopher Bruce Ellison | Social Worker | 809 19th Street, Middlesboro, KY 40965 | 2019-10-14 |
| 1982255030 | Johnny Wade Nantz II | Case Manager/Care Coordinator | 809 N 19th St, Middlesboro, KY 40965 | 2019-09-20 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1558843227 | Bethany Lauren Wade | Case Manager/Care Coordinator | 19th St, 809, Middlesboro, KY 40965 | 2018-08-30 |
| 1124521505 | Sonya Joyce Mcneil | Speech-Language Pathologist | Kidabilities Pediatric Therapy Center, 2801 Highway 25e, Suite 98, Middlesboro, KY 40965 | 2018-03-13 |
| 1518499862 | Vikki Lynn Johnson | Case Manager/Care Coordinator | 809 North 19th Street, Middlesboro, KY 40965 | 2017-03-28 |
| 1184164287 | Wilson Jeffrey | Occupational Therapist | Address: 235 New Wilson Lane, Middlesboro, KY 40965 | 2017-03-08 |
| 1447797444 | Lesha Loretta Williams | Physician Assistant | 2004 Cumberland Ave Ste 100, Middlesboro, KY 40965 | 2017-01-27 |
| 1619423910 | Audra Anissa Hall | Physical Therapist | 108 Turner Lane, Middlesboro, KY 40965 | 2016-08-28 |
| 1700332061 | Tammy Mclain | Counselor | Selfrefind 809 North 19th Street, Middlesboro, KY 40965 | 2016-08-28 |
| Find all providers in zip 40965 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962765578 | Appalachian Regional Healthcare, Inc. | Clinic/Center | 3602 Cumberland Ave, Suite 104, Middlesboro, KY 40965-2614 | 2012-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598383572 | Enhance The Aesthetic & Wellness Co. | Clinic/Center | 801 Country Club Ln, Hopkinsville, KY 42240-1370 | 2020-07-07 |
| 1679192611 | Temple Triage Pllc | Clinic/Center | 8209 Pennsylvania Run Rd, Louisville, KY 40228-2143 | 2020-04-09 |
| 1154966778 | Member Medical, Inc. | Clinic/Center | 3046 Dolphin Dr Ste 104, Elizabethtown, KY 42701-7182 | 2019-11-07 |
| 1104384213 | Directcare Family Health, Pllc | Clinic/Center | 525 High St Ste 209, Paris, KY 40361-1849 | 2019-03-07 |
| 1407311194 | Quad/med, LLC | Clinic/Center | 739 S Dixie St, Horse Cave, KY 42749 | 2019-02-06 |
| 1265906192 | Core Chiropractic and Family Wellness Pllc | Clinic/Center | 524 E.second St, Lexington, KY 40508 | 2019-01-14 |
| 1134606403 | Hope Primary & Urgent Care Pllc | Clinic/Center | 2157 S Highway 27, Stearns, KY 42647-6297 | 2018-07-19 |
| 1780177618 | Access Med, Pllc | Clinic/Center | 642 E Lexington Ave, Danville, KY 40422-1719 | 2018-06-14 |
| 1447743760 | Remedy House Calls | Clinic/Center | 37 Christopher Dr, South Shore, KY 41175-9447 | 2018-06-12 |
| 1932611019 | Family Care Professional Limited Liability Company | Clinic/Center | 3190 Irvine Rd., Richmond, KY 40475-4047 | 2017-10-30 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLESBORO |
| Zip Code | 40965 |
Please comment or provide details below to improve the information on MOUNTAIN COMPREHENSIVE HEALTH CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.