NPIMap

Organization Active NPI

Mt. Sterling Clinic, PLLC.

  • Internal Medicine Physician
  • Mt Sterling, KY
National Provider Identifier
1316920663
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MT. STERLING CLINIC, PLLC.
Practice address
100 Sterling Way
Suite 1
Mt. Sterling, KY 40353
Phone
(859) 498-0200
Fax
(859) 498-5812
NPI assigned
Nov 21, 2005
Last updated
May 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Authorized official

Name
Mr. Lon Edward Roberts, MDNPI 1942282538
Title
President
Phone
(859) 498-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

100 Sterling Way
Suite 1
Mt. Sterling, KY 40353

Mailing address

100 Sterling Way
Suite 1
Mt. Sterling, KY 40353
Phone (859) 498-0200

Other identifiers 1

IdentifierTypeStateIssuer
65937849MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040820001088 KY Part B Supplier - Clinic/Group Practice 3476527995 Receives reassigned benefits from 4 practitioners
Practice locations: Mt Sterling, KY

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
18D0322467Mt Sterling Clinic100 Sterling Way Suite 1, Mount Sterling, KY 40353Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26633/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274140800000",
    "number": "1316920663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STERLING WAY",
            "address_2": "SUITE 1",
            "city": "MT. STERLING",
            "state": "KY",
            "postal_code": "40353",
            "telephone_number": "859-498-0200",
            "fax_number": "859-498-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STERLING WAY",
            "address_2": "SUITE 1",
            "city": "MT. STERLING",
            "state": "KY",
            "postal_code": "40353",
            "telephone_number": "859-498-0200",
            "fax_number": "859-498-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. STERLING CLINIC, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2010-05-18",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "LON",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-498-0200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65937849",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.