NPIMap

Organization Active NPI

Family Health Care Associates 10

  • Rural Health Clinic/Center
  • Lancaster, KY
National Provider Identifier
1073267407
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FAMILY HEALTH CARE ASSOCIATES 10
Practice address
324 W Maple Ave
Lancaster, KY 40444-1171
Phone
(606) 546-7777
Fax
(855) 625-0821
NPI assigned
Feb 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Gina Good, APRNNPI 1831167584
Title
Owner/ Ceo
Phone
(606) 546-7777

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

324 W Maple Ave
Lancaster, KY 40444-1171

Mailing address

PO Box 1535
Barbourville, KY 40906-5535
Phone (606) 546-7777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220427002052 KY Part A Provider - Rural Health Clinic 8527455203 Practice locations: Lancaster, KY

Rural health clinic certification: CCN B03925

Legal name
FAMILY HEALTH CARE ASSOCIATES 10
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 25, 2023
Last certification
Jul 25, 2023
Ownership / control type
1A
Organization structure
LLCProprietary
Incorporated
Jan 31, 2022 in KY
Enrollment address
324 W Maple Ave
Lancaster, KY 40444-1171

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2252156Family Health Care Associates 10324 W Maple Ave, Lancaster, KY 40444Certificate of waiverFeb 8, 2028

National Provider Directory

National Provider Directory

Locations

324 W Maple Ave
Lancaster, KY 40444
Phone (606) 620-5087

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gina Good Individual 5% Or Greater Direct Ownership Interest Jan 31, 2022 100%
Operational/Managerial ControlCeo Jan 18, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Gina Good, APRN
    • Family Nurse Practitioner
    • Barbourville, KY
    • NPI 1831167584

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 10

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": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1073267407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409065535",
            "telephone_number": "606-546-7777",
            "fax_number": "855-625-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W MAPLE AVE",
            "city": "LANCASTER",
            "state": "KY",
            "postal_code": "404441171",
            "telephone_number": "606-546-7777",
            "fax_number": "855-625-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CARE ASSOCIATES 10",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "GOOD",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OWNER/ CEO",
        "authorized_official_telephone_number": "606-546-7777",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, KY

Sources for this page

Verify at the official NPI Registry.