NPIMap

Organization Active NPI

Mayfield Pediatric Clinic PLLC

Doing business as Mayfield Medical Center

  • Pediatrics Physician
  • Mayfield, KY
National Provider Identifier
1205079134
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MAYFIELD PEDIATRIC CLINIC PLLC
Doing business as
Mayfield Medical Center
Practice address
417 S 6TH St
Mayfield, KY 42066
Phone
(270) 247-1104
Fax
(270) 247-1107
NPI assigned
Apr 7, 2009
Last updated
Jul 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Abid Hussain, M.D.NPI 1164620340
Title
Owner
Phone
(270) 247-1104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 41115 KY
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 41115 KY
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 41115 KY
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

417 S 6TH St
Mayfield, KY 42066

Mailing address

417 S. 6TH St.
Mayfield, KY 42066
Phone (270) 247-1104

Other identifiers 1

IdentifierTypeStateIssuer
7100059060MedicaidKY

Other names 1

  • Mayfield Medical Center Doing business as

National Provider Directory

National Provider Directory

Locations

417 S 6th St
Ste 1
Mayfield, KY 42066

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1205079134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 S. 6TH ST.",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "42066",
            "telephone_number": "270-247-1104",
            "fax_number": "270-247-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 S 6TH ST",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "42066",
            "telephone_number": "270-247-1104",
            "fax_number": "270-247-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYFIELD PEDIATRIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "HUSSAIN",
        "authorized_official_first_name": "ABID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-247-1104",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "41115",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "41115",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "KY",
            "license": "41115",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100059060",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mayfield Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mayfield Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mayfield, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.