Manchester Family Practice Clinic

Key facts

NPI

1447201207

Entity type

Organization (NPI type 2)

Primary specialty

Family Medicine Physician 207Q00000X

License

900112 (KY)

Legal business name

MANCHESTER FAMILY PRACTICE CLINIC

Practice address

2734 S Highway 421
Manchester, KY 40962-7515

Phone

(606) 599-0609

Fax

(606) 599-8419

NPI assigned

May 15, 2006

Organization subpart

No

Authorized official

Name

Robert A. Carter Jr.

Title

President

Phone

(606) 528-0283

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Arden M Acob, MD Neurology Physician · Corbin, KY · NPI 1982614871
  NPD (past)
• Barbara Bargo, ARNP Nurse Practitioner · Bimble, KY · NPI 1346201936
  NPD (past) MULTI-SPECIALTY
• Gertrude A Morgan, CFNP Nurse Practitioner · Hazard, KY · NPI 1629019633
  NPD (past)
• Jackie C. Noland, ARNP Nurse Practitioner · Corbin, KY · NPI 1700989258
  NPD (past)
• Anne Encarnacion Agraviador Constantino, M.D. Neurology Physician · North Las Vegas, NV · NPI 1134197221
  NPD (past)

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 21, 2007.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1447201207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1125",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407021125",
            "telephone_number": "606-528-0283",
            "fax_number": "606-528-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2734 S HIGHWAY 421",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409627515",
            "telephone_number": "606-599-0609",
            "fax_number": "606-599-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER FAMILY PRACTICE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-528-0283",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "900112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35001072",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

• Carla Joan Lewis
• Living Clean LLC
• Cynthia Surer Maggard, ARNP
• Magnolia Tree Therapy, LLC
• Manchester Down Home Pharmacy LLC
• Manchester Family Practice Clinic, Inc.
• Manchester Pharmacist Group LLC
• Manchester Pharmacy LLC
• Manchester Prescription Center, LLC
• Manchester SNF Operations LLC

All providers in Manchester, KY · Family Medicine Physician in Kentucky