Organization Active NPI

Family Health Services, Inc.

  • Family Medicine Physician
  • Paintsville, KY
National Provider Identifier
1063450781
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
700135 Issued in KY
Legal business name
FAMILY HEALTH SERVICES, INC.
Practice address
824 FM Stafford Ave
Paintsville, KY 41240-1252
Phone
(606) 789-2424
Fax
(606) 789-2492
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Dedra D. Kretzer
Title
Presicent, Ceo
Phone
(606) 789-2424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 700135 KY Primary

Addresses

Primary practice location

824 FM Stafford Ave
Paintsville, KY 41240-1252

Mailing address

824 FM Stafford Ave
Paintsville, KY 41240-1252
Phone (606) 789-2424

Other identifiers 2

IdentifierTypeStateIssuer
65940199MedicaidKY
700135OtherKYPRIMARY CARE CENTER LICEN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063450781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 FM STAFFORD AVE",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401252",
            "telephone_number": "606-789-2424",
            "fax_number": "606-789-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 FM STAFFORD AVE",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401252",
            "telephone_number": "606-789-2424",
            "fax_number": "606-789-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRETZER",
        "authorized_official_first_name": "DEDRA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESICENT, CEO",
        "authorized_official_telephone_number": "606-789-2424",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "700135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65940199",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMARY CARE CENTER LICEN",
            "identifier": "700135",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paintsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.