Lewis County Primary Care Center, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

100989 Issued in KY

Legal business name

LEWIS COUNTY PRIMARY CARE CENTER, INC

Practice address

211 Ky 59
Vanceburg, KY 41179-7647

Phone

(606) 796-3029

Fax

(606) 796-6221

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Jerry Ugrin

Title

Ceo

Phone

(606) 796-3029

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fitness First & Rehab Center Doing business as

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1043336506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411790550",
            "telephone_number": "606-796-3029",
            "fax_number": "606-796-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 KY 59",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411797647",
            "telephone_number": "606-796-3029",
            "fax_number": "606-796-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS COUNTY PRIMARY CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "UGRIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-796-3029"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "KY",
            "license": "100989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31000268",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fitness First & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lewis County Health Department
• Lewis County Health Department
• Lewis County Health Department
• Lewis County Health Dept
• Lewis County Primary Care Center Pharmacy
• Lewis County Primary Care Center, Inc.
• Love Yourself Therapy
• Brandon Scott Malone, CNP
• Angela Marcum, RN
• Ronald D Mays, DMD

• Federally Qualified Health Center (FQHC) in Vanceburg, KY
• Providers in Vanceburg, KY by specialty
• Federally Qualified Health Center (FQHC) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.