Physicians for Families PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17220 Issued in KY

Legal business name

PHYSICIANS FOR FAMILIES PSC

Practice address

126 Portman Ave
Stanford, KY 40484-1230

Phone

(606) 365-9181

Fax

(606) 365-9183

NPI assigned

Oct 23, 2006

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Karen Click

Title

Office Manager

Phone

(606) 365-9181

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Fort Logan Clinic Former legal business name

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1346323383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 PORTMAN AVE",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404841230",
            "telephone_number": "606-365-9181",
            "fax_number": "606-365-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 PORTMAN AVE",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404841230",
            "telephone_number": "606-365-9181",
            "fax_number": "606-365-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS FOR FAMILIES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "CLICK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-365-9181",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "17220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64-172208",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65902140",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100228860",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Logan Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Family Medicine Physician in Stanford, KY
• Providers in Stanford, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.