Member Medical, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MEMBER MEDICAL, INC.

Practice address

3046 Dolphin Dr Ste 104
Elizabethtown, KY 42701-7182

Phone

(270) 307-1980

Fax

(270) 505-4204

NPI assigned

Nov 7, 2019

Organization subpart

No

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

Authorized official

Name

Sally Rineker

Title

Office Manager

Phone

(270) 307-1980

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1154966778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3046 DOLPHIN DR STE 104",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017182",
            "telephone_number": "270-307-1980",
            "fax_number": "270-505-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3046 DOLPHIN DR STE 104",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017182",
            "telephone_number": "270-307-1980",
            "fax_number": "270-505-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMBER MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "RINEKER",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-307-1980"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "270-505-4204",
            "affiliation": "N",
            "endpointDescription": "secure fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3046 Dolphin Dr Ste 104",
            "city": "Elizabethtown",
            "state": "KY",
            "country_code": "US",
            "postal_code": "427017182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Clinic/Center in Elizabethtown, KY
• Providers in Elizabethtown, 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 Nov 7, 2019; 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.