Family Medical Center

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

FAMILY MEDICAL CENTER

Practice address

306 Hospital Dr Ste 101
South Williamson, KY 41503-4023

Phone

(606) 237-1000

Fax

(606) 237-1001

NPI assigned

Aug 26, 2021

Last updated

Apr 13, 2023By 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

Mansoor Mahmood, MDNPI 1518046994

Title

Owner

Phone

(606) 371-0378

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417624586. Details of each certification follow.

• CCN B03888 Rural health clinic · Active · Details

Rural health clinic certification: CCN B03888

Legal name

FAMILY MEDICAL CENTER

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Mar 9, 2022

Last certification

Mar 9, 2022

Ownership / control type

1A

Organization structure

LLCProprietary

Enrollment address

306 Hospital Dr
Ste 101
South Williamson, KY 41503-4023

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

Owners & managing parties with NPI records 1

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

• Mansoor Mahmood

  • Internal Medicine Physician
  • Phelps, KY
  • NPI 1518046994

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

  CMS ownership

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.

• Mansoor Mahmood

  • Internal Medicine Physician
  • Phelps, KY
  • NPI 1518046994
  NPD Authorized official
• John Christopher Maynard, APRN FNP-BC

  • Family Nurse Practitioner
  • Prestonsburg, KY
  • NPI 1275157539
  NPD (past)

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1417624586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 PAULEY HOLW",
            "city": "FOREST HILLS",
            "state": "KY",
            "postal_code": "415278349",
            "telephone_number": "606-371-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 HOSPITAL DR STE 101",
            "city": "SOUTH WILLIAMSON",
            "state": "KY",
            "postal_code": "415034023",
            "telephone_number": "606-237-1000",
            "fax_number": "606-237-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "MAHMOOD",
        "authorized_official_first_name": "MANSOOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-371-0378",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Narpat S. Panwar, M.D., Inc.
• Eldron, Inc (Goody Economy Drug)
• Gregory Elliott, ABOC, NCLEC
• Nick Arnold England Jr., D.M.D.
• Lisa Kay Estep, NP
• Kelli J Farmer
• Hazel Maria Ferrell, P.T.
• Bryan Fields, PHARM.D.
• Chad Fite, M.D.
• Crystal Ann Fleming

• Rural Health Clinic/Center in South Williamson, KY
• Providers in South Williamson, KY by specialty
• Rural Health Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.