Clark Family Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

38679 Issued in KY

Legal business name

CLARK FAMILY CARE

Practice address

29 Canary LN
Winchester, KY 40391-1645

Phone

(859) 745-4469

Fax

(859) 745-6918

NPI assigned

Aug 9, 2006

Last updated

Dec 2, 2011By 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

Scott Moore, MD

Title

Owner

Phone

(859) 745-4469

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1427068626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CANARY LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911645",
            "telephone_number": "859-745-4469",
            "fax_number": "859-745-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 CANARY LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911645",
            "telephone_number": "859-745-4469",
            "fax_number": "859-745-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-745-4469",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "38679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA PROVIDER ID",
            "identifier": "1213053",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64075468",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "000000326872",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35001700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark County Health Department (Hannah McClure Elementary)
• 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 Infusion Group LLC (Clark Infusion Clinic)
• Clark Medical Ventures, LLC (Clark Family Care)
• Clark Pharmacists Group PLLC (Clark County Pharmacy)
• Clark Radiology, PLLC
• Clark Regional Medical Center

• Family Medicine Physician in Winchester, KY
• Providers in Winchester, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.