Ep Medical LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

EP MEDICAL LLC

Practice address

500 N Bypass Rd Ste C
Campbellsville, KY 42718-7792

Phone

(270) 789-0577

Fax

(270) 789-0578

NPI assigned

Jul 14, 2022

Organization subpart

No

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

Authorized official

Name

John R Eastridge, PHARMDNPI 1497308431

Title

Owner/Authorized Official

Phone

(270) 403-9333

Specialties & licenses 2

Addresses

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 4

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

• Maci McQueary, APRN

  • Family Nurse Practitioner
  • Campbellsville, KY
  • NPI 1104430297
  Medicare reassignment NPD
• Pavel Conovalciuc, MD

  • Family Medicine Physician
  • Spokane Valley, WA
  • NPI 1720017080

  KY

  Medicare reassignment NPD
• John R Eastridge, PHARM.D.

  • Pharmacist
  • Campbellsville, KY
  • NPI 1497308431
  NPD Authorized official
• Evelyn Cole Smith, PHARM.D.

  • Pharmacist
  • Campbellsville, KY
  • NPI 1306593942
  NPD (past)

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1235863218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N BYPASS RD STE C",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187792",
            "telephone_number": "270-789-0577",
            "fax_number": "270-789-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N BYPASS RD STE C",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187792",
            "telephone_number": "270-789-0577",
            "fax_number": "270-789-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EP MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "EASTRIDGE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "270-403-9333",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Edrington
• Keisha Ellis, PT
• Joshua David England, PHARMD
• Graham Dean Englund, M.D.
• Cecilee Ennis, MS, CFY/SLP
• Tracey G Evans
• Ewing-Ear, Nose & Throat
• James E Ewing, MD
• Extendicare Homes, Inc.
• Fast Pace Kentucky, PLLC

• Nurse Practitioner in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.