NPIMap

Organization Active NPI

Westlake Primary Care of Russell County Nursing Group

  • Family Nurse Practitioner
  • Russell Springs, KY
National Provider Identifier
1326210709
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3234P Issued in KY
Legal business name
WESTLAKE PRIMARY CARE OF RUSSELL COUNTY NURSING GROUP
Practice address
2465 Lakeway Drive
Russell Springs, KY 42642
Phone
(270) 858-3636
Fax
(270) 858-3660
NPI assigned
Mar 26, 2008
Organization subpart
Yes
Parent organization
ADAIR COUNTY HOSPITAL DISTRICTAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Rex A Tungate
Title
Ceo, Administrator
Phone
(270) 384-4753

Corporate family (same tax ID) 12

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

National Provider Directory

National Provider Directory
Tax ID family
Westlake Regional Hospital Medical Group (13 organizations share this tax ID)
Part of
Westlake Regional Hospital Medical Group

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 3234P KY Primary

Addresses

NPPES NPI Registry

Primary practice location

2465 Lakeway Drive
Russell Springs, KY 42642

Mailing address

2465 Lakeway Drive
Russell Springs, KY 42642
Phone (270) 858-3636

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
7890222800MedicaidKY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 26, 2008.

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1326210709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2465 LAKEWAY DRIVE",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "42642",
            "telephone_number": "270-858-3636",
            "fax_number": "270-858-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 LAKEWAY DRIVE",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "42642",
            "telephone_number": "270-858-3636",
            "fax_number": "270-858-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTLAKE PRIMARY CARE OF RUSSELL COUNTY NURSING GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADAIR COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "TUNGATE",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO, ADMINISTRATOR",
        "authorized_official_telephone_number": "270-384-4753"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3234P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7890222800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russell Springs, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.