NPIMap

Organization Active NPI

Lewis County Primary Care Center, Inc.

Doing business as Maysville OB/GYN Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Maysville, KY
National Provider Identifier
1275139453
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LEWIS COUNTY PRIMARY CARE CENTER, INC.
Doing business as
Maysville OB/GYN Family Health Center
Practice address
910 Kenton Station Dr
Maysville, KY 41056-9613
Phone
(606) 956-0188
NPI assigned
Dec 11, 2020
Last updated
Dec 11, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
LEWIS COUNTY PRIMARY CARE CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Authorized official

Name
Chad Erwin Evans
Title
Cco
Phone
(606) 956-0188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

910 Kenton Station Dr
Maysville, KY 41056-9613

Mailing address

PO Box 550
Vanceburg, KY 41179-0550
Phone (606) 956-0188

Other identifiers 1

IdentifierTypeStateIssuer
31000268MedicaidKY

Other names 1

  • Maysville OB/GYN Family Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275139453. Details of each certification follow.

  • CCN B01006 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN B01006

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MAYSVILLE OB/GYN FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 29, 2021
Last certification
Jan 29, 2021
Ownership / control type
For profit – partnership
Facility address
910 Kenton Station Drive
Maysville, KY 41056

National Provider Directory

National Provider Directory
Part of
Lewis County Primary Care Center Inc

NPI Registry JSON

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1275139453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411790550",
            "telephone_number": "606-956-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 KENTON STATION DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410569613",
            "telephone_number": "606-956-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS COUNTY PRIMARY CARE CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEWIS COUNTY PRIMARY CARE CENTER, INC.",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "ERWIN",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "606-956-0188"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31000268",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maysville OB/GYN Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maysville, KY

Sources for this page

Verify at the official NPI Registry.