Organization Active NPI

Nova Family Medicine Inc

  • Family Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1104943943
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5134P Issued in KY
Legal business name
NOVA FAMILY MEDICINE INC
Practice address
800 Cardinal Dr
#202
Elizabethtown, KY 42701-3902
Phone
(270) 735-1690
Fax
(270) 735-1696
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Authorized official

Name
Shelley L Roby
Title
Owner
Phone
(270) 735-1690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 5134P KY Primary

Addresses

Primary practice location

800 Cardinal Dr
#202
Elizabethtown, KY 42701-3902

Mailing address

800 Cardinal Dr
#202
Elizabethtown, KY 42701-3902
Phone (270) 735-1690

National Provider Directory

National Provider Directory

Locations

1002 Johnstown Rd
Ste 200
Elizabethtown, KY 42701
Phone (270) 735-1690

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1104943943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CARDINAL DR",
            "address_2": "#202",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013902",
            "telephone_number": "270-735-1690",
            "fax_number": "270-735-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CARDINAL DR",
            "address_2": "#202",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013902",
            "telephone_number": "270-735-1690",
            "fax_number": "270-735-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA FAMILY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "ROBY",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-735-1690"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "5134P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.