Faith Family Practice PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

FAITH FAMILY PRACTICE PLLC

Practice address

801 N. Main STR.
West Liberty, KY 41472-1021

Phone

(606) 743-1422

Fax

(606) 743-3044

NPI assigned

Apr 17, 2007

Last updated

Aug 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela M. Davis

Title

Office Manager

Phone

(606) 743-1422

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

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

Practitioners 2

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.

• Steven A Conrotto, MD

  • Family Medicine Physician
  • West Liberty, KY
  • NPI 1851440887
  Medicare reassignment Care Compare group
• L Brent Davis, PA-C

  • Medical Physician Assistant
  • West Liberty, KY
  • NPI 1366509416
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1154547347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MAIN ST",
            "city": "WEST LIBERTY",
            "state": "KY",
            "postal_code": "414721021",
            "telephone_number": "606-743-1422",
            "fax_number": "606-743-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N. MAIN STR.",
            "city": "WEST LIBERTY",
            "state": "KY",
            "postal_code": "414721021",
            "telephone_number": "606-743-1422",
            "fax_number": "606-743-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-743-1422"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65905721",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Lawrence Duff
• Bianca Dulin
• East Valley Elementary
• Tracy Jewell Elam, LCSW
• Phyllis Ann Eldridge
• Crystal Marie Fletcher-Jones, D.O.
• Frederick & Smith Inc (Clinic Pharmacy)
• Frederick Medical Clinic PSC
• James Denzil Frederick, MD
• Melissa Lynn Frederick, ARNP

• Primary Care Clinic/Center in West Liberty, KY
• Providers in West Liberty, KY by specialty
• Primary Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; 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.

Verify at the official NPI Registry.