Means Adult Primary Care Clinic of Kentucky PLLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MEANS ADULT PRIMARY CARE CLINIC OF KENTUCKY PLLC

Practice address

1145 W Lexington Ave FL 2
Winchester, KY 40391-1290

Phone

(859) 744-0301

Fax

(859) 744-0608

NPI assigned

Dec 2, 2019

Organization subpart

No

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

Authorized official

Name

Rezkalla Butros

Title

MD/Owner

Phone

(859) 499-0717

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

Rural health clinic certification: CCN B03948

Legal name

MEANS ADULT PRIMARY CARE CLINIC OF KENTUCKY PLLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Dec 7, 2023

Last certification

Dec 7, 2023

Ownership / control type

1B

Organization structure

OtherProprietary

Incorporated

Feb 6, 2003 in KY

Enrollment address

1145 W Lexington Ave
Winchester, KY 40391-1290

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Means Adult Primary Care Clinic of Kentucky PLLC

  • Rural Health Clinic/Center
  • Mt Sterling, KY
  • NPI 1205935814

  5395642177

  Same PAC ID
• Means Adult Primary Care Clinic of Kentucky PLLC

  • Rural Health Clinic/Center
  • Richmond, KY
  • NPI 1265294003

  5395642177

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Means Adult Primary Care Clinic of Kentucky PLLC

  • Rural Health Clinic/Center
  • Mt Sterling, KY
  • NPI 1205935814

  O20031218000659

  Same enrollment
• Means Adult Primary Care Clinic of Kentucky PLLC

  • Rural Health Clinic/Center
  • Richmond, KY
  • NPI 1265294003

  O20031218000659

  Same enrollment

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

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

Owners & managing parties with NPI records 1

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

• Rezkalla Butros, MD

  • Internal Medicine Physician
  • Mt. Sterling, KY
  • NPI 1023037082

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 2

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

• Kelsey Jude, PA

  • Physician Assistant
  • Lexington, KY
  • NPI 1518559905
  NPD
• Alexandra Pearcy, PA-C

  • Physician Assistant
  • Mount Sterling, KY
  • NPI 1871072991
  NPD (past)

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1124665807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 SKYVIEW DR",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403531496",
            "telephone_number": "859-499-0717",
            "fax_number": "859-499-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 W LEXINGTON AVE FL 2",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911290",
            "telephone_number": "859-744-0301",
            "fax_number": "859-744-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEANS ADULT PRIMARY CARE CLINIC OF KENTUCKY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-02",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "BUTROS",
        "authorized_official_first_name": "REZKALLA",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "859-499-0717"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100977320",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rex Powell McCrary, DMD
• Jessica Thomas McMaine, APRN
• David A. McMenamin, M.D.
• Pamela McMichael, SLP
• Christy McQuade, RPH
• Medibear Carehub
• Medical Advantage Carehub
• Angela Meeks, MAED, CF-SLP
• Tammy Melvin, LPN
• Mended Hearts Recovery LLC.

• Rural Health Clinic/Center in Winchester, KY
• Providers in Winchester, KY by specialty
• Rural Health Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.

Verify at the official NPI Registry.