Clark Infusion Group LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

CLARK INFUSION GROUP LLC

Doing business as

Clark Infusion Clinic

Practice address

124 Professional Ave
Winchester, KY 40391-1116

Phone

(859) 582-1730

NPI assigned

Jun 6, 2024

Last updated

Aug 1, 2024By 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

Kelsey Taylor Ruth

Title

Owner

Phone

(859) 582-1730

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clark Infusion Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 2

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.

• Robert Monty Cline II, D.O

  • Family Medicine Physician
  • Richmond, KY
  • NPI 1811344211
  Medicare reassignment NPD
• Keith Allen Everitt, APRN

  • Nurse Practitioner
  • Barbourville, KY
  • NPI 1942255245
  Medicare reassignment NPD

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1376384909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 LANA LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403912386",
            "telephone_number": "859-582-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 PROFESSIONAL AVE",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911116",
            "telephone_number": "859-582-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK INFUSION GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "RUTH",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-582-1730"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811344211",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Infusion Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clark County Health Department (Clark County Physical Therapy and Rehab)
• Clark County Health Department (Clark Middle School)
• Clark County Pharmacy, Inc
• Clark Emergency Physicians
• Clark Family Care
• Clark Medical Ventures, LLC (Clark Family Care)
• Clark Pharmacists Group PLLC (Clark County Pharmacy)
• Clark Radiology, PLLC
• Clark Regional Medical Center
• Clark Regional Medical Center, Inc

• Infusion Therapy Clinic/Center in Winchester, KY
• Providers in Winchester, KY by specialty
• Infusion Therapy Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.