Active NPI
Meade County Pediatrics PLLC
- Pediatrics Physician
- Brandenburg, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- MEADE COUNTY PEDIATRICS PLLC
- Practice address
- 1010 Lawrence Street
Brandenburg, KY 40108-1401 - Phone
- (270) 422-3400
- NPI assigned
- Feb 20, 2009
- Last updated
- Jun 14, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert L. Kupper
- Title
- Owner
- Phone
- (270) 422-3400
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | NU | ||
| Nurse Practitioner | 363L00000X | NU | ||
| Pediatrics Physician | 208000000X | NU | Primary |
Addresses
Primary practice location
1010 Lawrence Street
Brandenburg, KY 40108-1401
Mailing address
1010 Lawrence Street
Brandenburg, KY 40108-1401
Phone (270) 422-3400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090625000460 | KY | Part B Supplier - Clinic/Group Practice | 3173674520 | Practice locations: Brandenburg, KY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D1099915 | Meade County Pediatrics | Certificate of waiver | Dec 3, 2027 |
National Provider Directory
National Provider DirectoryLocations
1010 Lawrence St
Brandenburg, KY 40108
Phone (270) 422-3400
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pediatrics Physician
- Brandenburg, KY
- NPI 1134382625
-
- Physician Assistant
- Louisville, KY
- NPI 1407203862
-
- Family Nurse Practitioner
- Elizabethtown, KY
- NPI 1114437795
-
- Family Nurse Practitioner
- Brandenburg, KY
- NPI 1174866636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235088000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655164800000",
"number": "1083854731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 LAWRENCE STREET",
"city": "BRANDENBURG",
"state": "KY",
"postal_code": "401081401",
"telephone_number": "270-422-3400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 LAWRENCE STREET",
"city": "BRANDENBURG",
"state": "KY",
"postal_code": "401081401",
"telephone_number": "270-422-3400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEADE COUNTY PEDIATRICS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-02-20",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A",
"authorized_official_last_name": "KUPPER",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "270-422-3400"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brandenburg, KY
- Katrina Ray McCoy, APRN
- Meade Association of Remarkable Citizens (MARC Anchor House)
- Meade County Board of Education
- Meade County Chiropractic & Sports Rehab PSC
- Meade County Fiscal Court (Meade County Ambulance)
- Meade Family Eye, PLLC
- Meade Physicians, Inc. (Brandenburg Family Medicine)
- Medical Center Cardiologists, PSC
- Milestones Speech Therapy LLC
- Joseph Andrew Miller, D.M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.