NPIMap

Southfork Medical Clinic PLLC

A Medicare group practice based in Whitley City, KY: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 7012815616), with 7 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
7012815616The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Rural Health Clinic, Part B Supplier - Clinic/Group Practice
Enrolled in
KY
Enrollments
3
Group size
4 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
3In 1 place

Enrollment records 3

Enrollment IDStateProvider typeNPI
O20040602001146 KY Part B Supplier - Clinic/Group Practice 1205616265
O20031220000018 KY Part A Provider - Rural Health Clinic 1295718757
O20240614001045 KY Part A Provider - Rural Health Clinic 1205616265

NPIs in this group 2

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 7

Clinicians who reassign their Medicare benefits to this group (7) or whom Care Compare lists as members (4).

Sources for this page