Rockcastle River Family Health Clinic PLLC

Key facts

NPI: 1265909121
Entity type: Organization (NPI type 2)
Primary specialty: Nurse Practitioner 363L00000X
Legal business name: ROCKCASTLE RIVER FAMILY HEALTH CLINIC PLLC
Practice address: 9226 Main St
Livingston, KY 40445
Phone: (606) 453-3901
NPI assigned: Oct 30, 2018
Organization subpart: No

Authorized official

Name: Dawn Carpenter, APRN NPI 1790033934
Title: Owner
Phone: (606) 453-3901

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

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

Dawn Rene' Carpenter, APRN Family Nurse Practitioner · Livingston, KY · NPI 1790033934

Medicare reassignment Care Compare group NPD Authorized official KY
Kathryn Lauren Hayes, APRN Family Nurse Practitioner · Lexington, KY · NPI 1831854934

Medicare reassignment Care Compare group NPD KY

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
18D2166437	Rockcastle River Family Health Clinic 9226 Main St, Ste D, Livingston, KY 40445	Certificate of waiver	May 16, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in KY

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20190515001943	KY	Part B Supplier - Clinic/Group Practice	9133464787	Receives reassigned benefits from 2 practitioners Practice locations: Livingston, KY

National Provider Directory

Locations

811 Corporate Dr
Ste 205
Lexington, KY 40503

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nurse Practitioner Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	363L00000X			Yes

Addresses

Primary practice location

9226 Main St
Livingston, KY 40445

Mailing address

502 S Upper River Rd
Livingston, KY 40445-8743
Phone (606) 453-3901

Other providers in Livingston, KY

Dawn Rene' Carpenter, APRN

All providers in Livingston, KY · Nurse Practitioner in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.