Active NPI
Vip Community Health LLC
- Rural Health Clinic/Center
- Lawrenceburg, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- VIP COMMUNITY HEALTH LLC
- Practice address
- 503 Humston Dr
Lawrenceburg, KY 40342-1927 - Phone
- (270) 543-7557
- NPI assigned
- May 9, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Debra Hardison, APRN
- Title
- Owner
- Phone
- (270) 543-7557
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
503 Humston Dr
Lawrenceburg, KY 40342-1927
Mailing address
3064 Pea Ridge Rd
Waddy, KY 40076-6107
Phone (270) 543-7557
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230811003031 | KY | Part B Supplier - Clinic/Group Practice | 7618339326 |
Receives reassigned benefits from 7 practitioners 1 other NPI on this enrollment Practice locations: Lawrenceburg, KY |
| O20241202002102 | KY | Part A Provider - Rural Health Clinic | 7618339326 | Practice locations: Lawrenceburg, KY |
Rural health clinic certification: CCN B03970
- Legal name
- VIP COMMUNITY HEALTH LLC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Mar 17, 2025
- Last certification
- Mar 17, 2025
- Ownership / control type
- 1C
- Organization structure
- LLC
- Enrollment address
- 503 Humston Dr
Lawrenceburg, KY 40342-1927
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Multi-Specialty Clinic/Center
- Lawrenceburg, KY
- NPI 1568152098
O20230811003031
National Provider Directory
National Provider DirectoryLocations
503 Humston Dr
Lawrenceburg, KY 40342
Phone (502) 353-0102
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Debra L Hardison | 5% Or Greater Direct Ownership Interest | Mar 28, 2023 | 100% |
| Corporate Officer | Mar 28, 2023 | 100% | |
| Operational/Managerial Control | Mar 28, 2023 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Adult Health Nurse Practitioner
- Lawrenceburg, KY
- NPI 1851922744
5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Bowling Green, KY
- NPI 1790091080
KY
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683590400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1744156800000",
"number": "1457041980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3064 PEA RIDGE RD",
"city": "WADDY",
"state": "KY",
"postal_code": "400766107",
"telephone_number": "270-543-7557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 HUMSTON DR",
"city": "LAWRENCEBURG",
"state": "KY",
"postal_code": "403421927",
"telephone_number": "270-543-7557"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIP COMMUNITY HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-05-09",
"last_updated": "2025-04-09",
"certification_date": "2025-04-09",
"status": "A",
"authorized_official_last_name": "HARDISON",
"authorized_official_first_name": "DEBRA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "270-543-7557",
"authorized_official_credential": "APRN"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.