NPIMap

Organization Active NPI

Rural Health PLLC

Doing business as Berea Walk-In Clinic

  • Internal Medicine Physician
  • Berea, KY
National Provider Identifier
1437574613
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32006 Issued in KY
Legal business name
RURAL HEALTH PLLC
Doing business as
Berea Walk-In Clinic
Practice address
295 Paint Lick Rd
Berea, KY 40403-8078
Phone
(859) 986-0375
Fax
(859) 368-7681
NPI assigned
Feb 25, 2014
Last updated
Sep 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Authorized official

Name
Fadi Bacha, MDNPI 1639157456
Title
President/Owner
Phone
(859) 312-9674

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1103 KY
Nurse Practitioner 363L00000X 3008382 KY
Internal Medicine Physician 207R00000X 32006 KY Primary

Addresses

Primary practice location

295 Paint Lick Rd
Berea, KY 40403-8078

Mailing address

245 Prince Royal Dr
Suite a
Berea, KY 40403-1471
Phone (859) 582-7663

Other names 1

  • Berea Walk-In Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140423001232 KY Part B Supplier - Clinic/Group Practice 6901039197 Receives reassigned benefits from 7 practitioners
Practice locations: Berea, KY
O20160421002399 KY Part A Provider - Rural Health Clinic 6901039197 Practice locations: Berea, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437574613. Details of each certification follow.

Rural health clinic certification: CCN 188955

Legal name
RURAL HEALTH PLLC
Doing business as
BEREA WALK IN CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 8, 2016
Last certification
Mar 4, 2026
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Dec 10, 2013 in KY
Enrollment address
245 Prince Royal Dr
Ste a
Berea, KY 40403-1471

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
18D2077904Berea Walk-in Clinic295 Paint Lick Rd, Berea, KY 40403Certificate of waiverMay 18, 2028

National Provider Directory

National Provider Directory

Locations

245 Prince Royal Dr
Ste A
Berea, KY 40403
Phone (859) 986-0375

Ownership & related parties

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.

NameRoleSinceShare
Kim Aprn Cox Individual 5% Or Greater Direct Ownership InterestOwner May 16, 2025 100%
W-2 Managing EmployeeCeo; Aprn May 16, 2025

Owners & managing parties with NPI records 1

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

  • Kim B Cox, APRN
    • Psychiatric/Mental Health Nurse Practitioner
    • Booneville, KY
    • NPI 1326131434

    5% Or Greater Direct Ownership Interest, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1437574613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 PRINCE ROYAL DR",
            "address_2": "SUITE A",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031471",
            "telephone_number": "859-582-7663",
            "fax_number": "859-335-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 PAINT LICK RD",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404038078",
            "telephone_number": "859-986-0375",
            "fax_number": "859-368-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-25",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "BACHA",
        "authorized_official_first_name": "FADI",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "859-312-9674",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1103",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3008382",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "32006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Berea Walk-In Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.