Organization Active NPI

Letek PLLC

  • Primary Care Clinic/Center
  • Mount Vernon, KY
National Provider Identifier
1043766801
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
38140 Issued in KY
Legal business name
LETEK PLLC
Practice address
75 East Main Street
Mount Vernon, KY 40456
Phone
(859) 358-1023
Fax
(606) 392-2139
NPI assigned
Aug 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Authorized official

Name
Dr. Thomas William Fowles, M.D.NPI 1285679100
Title
Owner
Phone
(859) 358-3069

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 38140 KY
Primary Care Clinic/Center 261QP2300X 38140 KY Primary

Addresses

Primary practice location

75 East Main Street
Mount Vernon, KY 40456

Mailing address

409 Forest Trail Dr
Berea, KY 40403-9690
Phone (731) 571-9223

Other identifiers 2

IdentifierTypeStateIssuer
64102726MedicaidKY
7846668OtherKYAETNA PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170125002448 KY Part B Supplier - Clinic/Group Practice 3476835570 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Vernon, KY

National Provider Directory

National Provider Directory

Locations

942 W Main St
Unit B
Mount Vernon, KY 40456
Phone (606) 392-2207

75 Main St
Mount Vernon, KY 40456

225 E State Route 14
Ste 102
Columbiana, OH 44408
Phone (330) 729-1934

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1043766801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 FOREST TRAIL DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404039690",
            "telephone_number": "731-571-9223",
            "fax_number": "931-901-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 EAST MAIN STREET",
            "city": "MOUNT VERNON",
            "state": "KY",
            "postal_code": "40456",
            "telephone_number": "859-358-1023",
            "fax_number": "606-392-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LETEK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "FOWLES",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-358-3069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "38140",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "38140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64102726",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7846668",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.