NPIMap

Organization Active NPI

Rockcastle County Hospital, Inc.

Doing business as Rockcastle Family Wellness

  • Rural Health Clinic/Center
  • Mount Vernon, KY
National Provider Identifier
1255645040
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
100374 Issued in KY
Legal business name
ROCKCASTLE COUNTY HOSPITAL, INC.
Doing business as
Rockcastle Family Wellness
Practice address
140 Newcomb Ave
Mount Vernon, KY 40456-2728
Phone
(606) 256-4148
Fax
(606) 256-7410
NPI assigned
Aug 4, 2010
Last updated
Feb 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Authorized official

Name
Mrs. Brandy L Bullock
Title
Administrator
Phone
(606) 256-7761

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 100374 KY Primary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Rheumatology Physician 207RR0500X
Gynecology Physician 207VG0400X
Pediatrics Physician 208000000X
Neurology Physician 2084N0400X

Addresses

Primary practice location

140 Newcomb Ave
Mount Vernon, KY 40456-2728

Mailing address

140 Newcomb Ave
Mount Vernon, KY 40456-2728
Phone (606) 256-4148

Other identifiers 2

IdentifierTypeStateIssuer
900239OtherKYSTATE LICENSE NUMBER
K017200OtherMEDICARE PART B

Other names 1

  • Rockcastle Family Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040119000523 KY Part B Supplier - Clinic/Group Practice 6103727433 Receives reassigned benefits from 65 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Vernon, KY; Mt Vernon, KY; Broadhead, KY
O20101013000059 KY Part A Provider - Rural Health Clinic 6103727433 Practice locations: Mount Vernon, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255645040. Details of each certification follow.

Rural health clinic certification: CCN 183467

Legal name
ROCKCASTLE COUNTY HOSPITAL, INC.
Doing business as
ROCKCASTLE FAMILY WELLNESS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 4, 2010
Last certification
Jun 16, 2016
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
May 1, 1957 in KY
Enrollment address
140 Newcomb Ave
Mount Vernon, KY 40456-2725
Related CCNs
180115

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0706966Rockcastle Family Wellness140B Newcomb Avenue, Mount Vernon, KY 40456Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

140 Newcomb Ave
Ste B
Mount Vernon, KY 40456

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bige Towery Individual Corporate DirectorVice Chairman & Secretary Jul 28, 2010
Joseph Lambert Individual Corporate DirectorBoard Chairman Jul 28, 2010
Stephen Estes Individual Corporate OfficerCeo Mar 3, 1983
W-2 Managing EmployeeCeo Mar 3, 1983
Christopher Bastin Individual Corporate OfficerCfo Nov 1, 2013
W-2 Managing EmployeeCfo Nov 1, 2013
Jeffrey Burdette Individual Corporate DirectorMember Jul 28, 2010
Debra Lambert Individual Corporate DirectorMember Jul 28, 2010

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lifeline Rockcastle Home HealthMt Vernon, KY, CCN 187172 Home health agency 5% Or Greater Direct Ownership Interest (25%) Nov 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 52

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.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393545600000",
    "number": "1255645040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 NEWCOMB AVE",
            "city": "MOUNT VERNON",
            "state": "KY",
            "postal_code": "404562728",
            "telephone_number": "606-256-4148",
            "fax_number": "606-256-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 NEWCOMB AVE",
            "city": "MOUNT VERNON",
            "state": "KY",
            "postal_code": "404562728",
            "telephone_number": "606-256-4148",
            "fax_number": "606-256-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKCASTLE COUNTY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-04",
        "last_updated": "2014-02-28",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "606-256-7761",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "100374",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "900239",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "K017200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockcastle Family Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, KY

Sources for this page

Verify at the official NPI Registry.