NPIMap

Organization Active NPI

Clark Regional Medical Center, Inc

  • Physical Therapy Clinic/Center
  • Winchester, KY
National Provider Identifier
1366460818
Registry record updated May 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
100902 Issued in KY
Legal business name
CLARK REGIONAL MEDICAL CENTER, INC
Practice address
1934 Bypass Rd
Winchester, KY 40391-2389
Phone
(859) 745-0191
Fax
(859) 745-7789
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2010

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

Authorized official

Name
Mr. Robert D Fraraccio
Title
Chief Financial Officer
Phone
(859) 745-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 100902 KY Primary

Addresses

Primary practice location

1934 Bypass Rd
Winchester, KY 40391-2389

Mailing address

1107 W Lexington Ave
Winchester, KY 40391-1169
Phone (859) 745-3500

Other identifiers 3

IdentifierTypeStateIssuer
032043100OtherKYBLACK LUNG
000000054543OtherKYBLUE CROSS
01007335MedicaidKY

Other names 1

  • Clark Immediate Care Center Rehabilitation Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1366460818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 W LEXINGTON AVE",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911169",
            "telephone_number": "859-745-3500",
            "fax_number": "859-745-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 BYPASS RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403912389",
            "telephone_number": "859-745-0191",
            "fax_number": "859-745-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "FRARACCIO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "859-745-3500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "KY",
            "license": "100902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "032043100",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000054543",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01007335",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Immediate Care Center Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; 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.