NPIMap

Organization Active NPI

East Bernstadt Medical Clinic PLLC

  • Rural Health Clinic/Center
  • London, KY
National Provider Identifier
1245299585
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
EAST BERNSTADT MEDICAL CLINIC PLLC
Practice address
2659 N Laurel Rd
London, KY 40741-9075
Phone
(606) 843-6195
Fax
(606) 843-6222
NPI assigned
Mar 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Carla Jean Johnson
Title
Billing/Credentialing Clerk
Phone
(606) 843-6195

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

2659 N Laurel Rd
London, KY 40741-9075

Mailing address

2659 N Laurel Rd
London, KY 40741-9075
Phone (606) 843-6195

Other identifiers 6

IdentifierTypeStateIssuer
65907750MedicaidKY
7100163280MedicaidKY
7100045270MedicaidKY
7100048870MedicaidKY
7100163300MedicaidKY
7100163320MedicaidKY

Other names 2

  • East Bernstadt Medical Clinic Doing business as
  • East Bernstadt Medical Clinic PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
David J Hays5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1245299585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2659 N LAUREL RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407419075",
            "telephone_number": "606-843-6195",
            "fax_number": "606-843-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 N LAUREL RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407419075",
            "telephone_number": "606-843-6195",
            "fax_number": "606-843-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BERNSTADT MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING CLERK",
        "authorized_official_telephone_number": "606-843-6195"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65907750",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100163280",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100045270",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100048870",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100163300",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100163320",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Bernstadt Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Bernstadt Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Bernstadt Medical Clinic PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.