CLINCH RIVER HEALTH SERVICES, INC.
NPI 1508845389
Clinic/Center - Federally Qualified Health Center (FQHC) in Dungannon, VA
About Clinch River Health Services, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLINCH RIVER HEALTH SERVICES, INC. (NPI 1508845389) is a healthcare organization registered as a federally qualified health center (fqhc) in Dungannon, Virginia and active in the NPI registry since January 2006. The organization holds a CLIA Microscopy certificate valid through March 22, 2027 and lists Gary Gilliam, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Clinch River Health Services, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
11Medicare enrollment records show 11 clinicians reassign Medicare billing to Clinch River Health Services, Inc., which bills Medicare for the services they deliver. Of these, 8 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (11)
Dungannon, VA 24245
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D0684301
Clinch River Health Services Inc · Dungannon, VAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Clinch River Health Services, Inc.'s NPI number?
The NPI number for Clinch River Health Services, Inc. is 1508845389. It was assigned to this organization in the NPPES registry on January 11, 2006.
Where is Clinch River Health Services, Inc. located?
Clinch River Health Services, Inc. is located at 17633 Veterans Memorial Hwy Suite 101, Dungannon, VA 24245. The listed phone number is (276) 467-2201.
What is Clinch River Health Services, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Clinch River Health Services, Inc. enrolled in Medicare?
Yes. Clinch River Health Services, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Clinch River Health Services, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 3 Medicare specialties reassign their Medicare billing to Clinch River Health Services, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (8), Clinical Social Worker (2) and Family Practice (1). Of these, 8 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Clinch River Health Services, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 49D0684301) is associated with this NPI, valid through March 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Clinch River Health Services, Inc. was last updated on February 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Clinch River Health Services, Inc. · NPI 1508845389
Federally Qualified Health Center (FQHC) organization in Dungannon, Virginia. Organization record, active in the CMS NPPES registry since January 11, 2006.
## Identity
- **NPI:** 1508845389 (Entity type: Organization)
- **Enumerated:** January 11, 2006
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Organization subpart:** No
- **Authorized official:** Gary Gilliam, ADMINISTRATOR
## Practice location
- **Address:** 17633 VETERANS MEMORIAL HWY, SUITE 101, Dungannon, VA 24245
- **Phone:** (276) 467-2201 · **Fax:** (276) 467-2673
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 11 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (8), Clinical Social Worker (2), Family Practice (1); 8 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 25, 2022
- **Other identifiers:** Medicaid 007639431 (VA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1508845389) · Data from the CMS NPPES public registry.