Ertel Medicine & Pediatrics, PSC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

900132 Issued in KY

Legal business name

ERTEL MEDICINE & PEDIATRICS, PSC

Practice address

1520 Boonesboro Rd
Winchester, KY 40391-8816

Phone

(859) 744-0067

Fax

(859) 744-0042

NPI assigned

Jun 25, 2006

Organization subpart

No

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

Authorized official

Name

Larry Ertel, M.D.

Title

Owner

Phone

(859) 744-0067

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408665600000",
    "number": "1003842501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 BOONESBORO RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403918816",
            "telephone_number": "859-744-0067",
            "fax_number": "859-744-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 BOONESBORO RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403918816",
            "telephone_number": "859-744-0067",
            "fax_number": "859-744-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERTEL MEDICINE & PEDIATRICS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2014-08-22",
        "status": "A",
        "authorized_official_last_name": "ERTEL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-744-0067",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "35650",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "900132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Ely, LCSW
• Matthew Drew Enz, OTR/L
• Caleb Epperson, PHARMD, RPH
• Alexa Erkman, CCC-SLP
• Amber Ernstberger, SLP
• Horace Wayne Evans, OT
• Evergreen Medical Transportation, LLC
• Daniel A Ewen, MD
• Donna Fairchild, CRNA
• James K Farris, PA

• Rural Health Clinic/Center in Winchester, KY
• Providers in Winchester, KY by specialty
• Rural Health Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.