Maguet Medical Center LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MAGUET MEDICAL CENTER LLC

Practice address

40 Moonbow PLZ Ste 1
Corbin, KY 40701-8983

Phone

(606) 215-3488

Fax

(606) 280-4015

NPI assigned

Jul 25, 2022

Organization subpart

No

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

Authorized official

Name

Devonna Maguet, APRNNPI 1992066559

Title

Owner

Phone

(606) 215-3488

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164158937. Details of each certification follow.

• CCN B03920 Rural health clinic · Active · Details

Rural health clinic certification: CCN B03920

Legal name

MAGUET MEDICAL CENTER LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Mar 28, 2023

Last certification

Mar 28, 2023

Ownership / control type

1A

Organization structure

LLCProprietary

Enrollment address

40 Moonbow PLZ
Ste 1
Corbin, KY 40701-8983

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

CLIA laboratory certificates

All disclosed owners & managing parties 1

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.

• Devonna Giles Maguet, APRN

  • Family Nurse Practitioner
  • Corbin, KY
  • NPI 1992066559

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

  CMS ownership

Practitioners 1

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.

• Devonna Giles Maguet, APRN

  • Family Nurse Practitioner
  • Corbin, KY
  • NPI 1992066559
  NPD Authorized official

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1164158937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MOONBOW PLZ STE 1",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018983",
            "telephone_number": "606-215-3488",
            "fax_number": "606-280-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MOONBOW PLZ STE 1",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018983",
            "telephone_number": "606-215-3488",
            "fax_number": "606-280-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGUET MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-25",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "MAGUET",
        "authorized_official_first_name": "DEVONNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-215-3488",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Lee Mackey, M.D.
• Robert Edward Mackey, O.D.
• Chasity Mafnas
• Justin Maggard, PHARMD
• Lisa Marie Maggard, BA
• Devonna Giles Maguet, APRN
• Jeffrey Maguet, P.T.
• Matt Maguet, D.P.T
• April Nicole Mahan, BS
• Donna Jo Mahan, LPCC, CADC

• Rural Health Clinic/Center in Corbin, KY
• Providers in Corbin, 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 Jan 24, 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.