Organization Active NPI

Healthcore Family Practice, PLLC

  • Primary Care Clinic/Center
  • Georgetown, KY
National Provider Identifier
1376188276
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HEALTHCORE FAMILY PRACTICE, PLLC
Practice address
103 Boston SQ
Georgetown, KY 40324-9746
Phone
(859) 619-5488
Fax
(502) 570-9269
NPI assigned
Nov 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Authorized official

Name
Barbara Baker, APRNNPI 1598833295
Title
Aprn/President
Phone
(859) 619-5488

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

103 Boston SQ
Georgetown, KY 40324-9746

Mailing address

107 Broadbill CT
Georgetown, KY 40324-9294
Phone (859) 619-5488

Other identifiers 1

IdentifierTypeStateIssuer
7100243400MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191219001884 KY Part B Supplier - Clinic/Group Practice 7214361542 Receives reassigned benefits from 1 practitioner
Practice locations: Georgetown, 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
18D2173426Healthcore Family Practice103 Boston Square, Georgetown, KY 40324Certificate of waiverOct 13, 2027

National Provider Directory

National Provider Directory

Locations

103 Boston Sq
Georgetown, KY 40324
Phone (502) 603-8152

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20583/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1376188276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BROADBILL CT",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249294",
            "telephone_number": "859-619-5488",
            "fax_number": "502-570-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BOSTON SQ",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249746",
            "telephone_number": "859-619-5488",
            "fax_number": "502-570-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCORE FAMILY PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "APRN/PRESIDENT",
        "authorized_official_telephone_number": "859-619-5488",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100243400",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.