NPIMap

Organization Active NPI

Community Care of Kentucky Inc.

  • General Practice Dentistry
  • Benton, KY
National Provider Identifier
1407262181
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMMUNITY CARE OF KENTUCKY INC.
Practice address
267 Slickback Rd
Benton, KY 42025-7629
Phone
(270) 527-1496
Fax
(270) 527-5321
NPI assigned
Jul 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Authorized official

Name
Mrs. Marlen Whitmore, B.S.
Title
Credentialing Manager
Phone
(256) 241-1698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

267 Slickback Rd
Benton, KY 42025-7629

Mailing address

PO Box 2369
Anniston, AL 36202-2369
Phone (256) 241-3965

National Provider Directory

National Provider Directory
Tax ID family
Community Care of Kentucky Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

267 Slickback Rd
Benton, KY 42025
Phone (270) 527-1496

NPI Registry JSON

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1407262181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2369",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362022369",
            "telephone_number": "256-241-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 SLICKBACK RD",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257629",
            "telephone_number": "270-527-1496",
            "fax_number": "270-527-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE OF KENTUCKY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "WHITMORE",
        "authorized_official_first_name": "MARLEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "256-241-1698",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.