NPIMap

Organization Active NPI

United Clinics of Kentucky LLC

Doing business as United Clinics West Liberty

  • Rural Health Clinic/Center
  • West Liberty, KY
National Provider Identifier
1356907224
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
UNITED CLINICS OF KENTUCKY LLC
Doing business as
United Clinics West Liberty
Practice address
633 Prestonsburg St
West Liberty, KY 41472
Phone
(606) 743-3477
NPI assigned
May 15, 2019
Last updated
May 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Authorized official

Name
Nadeem Shaikh, MDNPI 1447221957
Title
Owner
Phone
(606) 743-3477

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

633 Prestonsburg St
West Liberty, KY 41472

Mailing address

PO Box 220
Campton, KY 41301-0220
Phone (606) 743-3477

Other names 1

  • United Clinics West Liberty Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050225000679 KY Part B Supplier - Clinic/Group Practice 2668457094 Receives reassigned benefits from 20 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beattyville, KY; Campton, KY; Jackson, KY; West Liberty, KY; Winchester, KY
O20191105001994 KY Part A Provider - Rural Health Clinic 2668457094 Practice locations: West Liberty, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356907224. Details of each certification follow.

Rural health clinic certification: CCN B03812

Legal name
UNITED CLINICS OF KENTUCKY LLC
Doing business as
UNITED CLINICS OF WEST LIBERTY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 27, 2020
Last certification
Feb 27, 2020
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Apr 14, 2004 in KY
Enrollment address
633 Prestonsburg St
West Liberty, KY 41472

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
18D2166667United Clinics West Liberty633 Prestonsburg Street, West Liberty, KY 41472Certificate of waiverMay 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
United Clinics of Kentucky LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nadeem Shaikh Individual 5% Or Greater Direct Ownership Interest Apr 14, 2004 100%
Corporate OfficerPresident Apr 14, 2004
W-2 Managing EmployeePresident Apr 14, 2004

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Nadeem Shaikh, M.D.
    • Internal Medicine Physician
    • Campton, KY
    • NPI 1447221957

    5% Or Greater Direct Ownership Interest, Corporate Officer, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1356907224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "CAMPTON",
            "state": "KY",
            "postal_code": "413010220",
            "telephone_number": "606-743-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 PRESTONSBURG ST",
            "city": "WEST LIBERTY",
            "state": "KY",
            "postal_code": "41472",
            "telephone_number": "606-743-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CLINICS OF KENTUCKY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "SHAIKH",
        "authorized_official_first_name": "NADEEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-743-3477",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Clinics West Liberty",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Liberty, KY

Sources for this page

Verify at the official NPI Registry.