NPIMap

Organization Active NPI

Lewis County Primary Care Center, Inc.

Doing business as PrimaryPlus

  • Federally Qualified Health Center (FQHC)
  • Vanceburg, KY
National Provider Identifier
1457303802
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
700041 Issued in KY
Legal business name
LEWIS COUNTY PRIMARY CARE CENTER, INC.
Doing business as
PrimaryPlus
Practice address
211 Ky 59
Vanceburg, KY 41179-9719
Phone
(606) 796-3029
Fax
(606) 796-6221
NPI assigned
May 16, 2006
Last updated
Jan 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
Jerry G Ugrin
Title
Ceo
Phone
(606) 796-3029

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 700041 KY Primary

Addresses

Primary practice location

211 Ky 59
Vanceburg, KY 41179-9719

Mailing address

PO Box 550
Vanceburg, KY 41179-0550
Phone (606) 796-3029

Other identifiers 2

IdentifierTypeStateIssuer
0864613MedicaidOH
31000268MedicaidKY

Other names 1

  • PrimaryPlus Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040515000278 KY Part B Supplier - Clinic/Group Practice 1153311774 Receives reassigned benefits from 92 practitioners
Practice locations: Ashland, KY; Vanceburg, KY; Tollesboro, KY; South Shore, KY; Mount Olivet, KY; Morehead,, KY; Maysville, KY; Grayson, KY…
O20100721000945 KY Part A Provider - Federally Qualified Health Center (FQHC) 1153311774 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tollesboro, KY
O20100726000097 KY Part A Provider - Federally Qualified Health Center (FQHC) 1153311774 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Maysville, KY
O20100909000599 KY Part A Provider - Federally Qualified Health Center (FQHC) 1153311774 Practice locations: Vanceburg, KY

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1457303802. Details of each certification follow.

Federally qualified health center certification: CCN 181845

Legal name
LEWIS COUNTY PRIMARY CARE CENTER, INC
Doing business as
TOLLESBORO FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 8, 2004
Last certification
Sep 8, 2004
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
May 27, 1983 in KY
Enrollment address
17521 W Ky 9
Tollesboro, KY 41189-8243

Federally qualified health center certification: CCN 181849

Legal name
LEWIS COUNTY PRIMARY CARE CENTER, INC
Doing business as
MAYSVILLE OB/GYN FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 22, 2005
Last certification
Jul 22, 2005
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
May 27, 1983 in KY
Enrollment address
927 Kenton Station Dr
Maysville, KY 41056-9617

Federally qualified health center certification: CCN 181818

Legal name
LEWIS COUNTY PRIMARY CARE CENTER, INC
Doing business as
PRIMARYPLUS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 1, 1991
Last certification
Dec 1, 1991
Ownership / control type
Non-profit – other
Organization structure
CorporationNon-profit
Incorporated
May 27, 1983 in KY
Enrollment address
211 Ky 59
BLDG a
Vanceburg, KY 41179-7647

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

520 Elizaville Ave
Flemingsburg, KY 41041
Phone (606) 845-0028

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael Thoroughman Individual Corporate OfficerCfo Aug 1, 2016
Michael Kennedy Individual Corporate DirectorBoard Member Apr 14, 2016
Jerry G Ugrin Individual Corporate DirectorCeo Jan 1, 1988
W-2 Managing EmployeeCeo Jan 1, 1988
Corporate OfficerCeo Jan 1, 1988
Corporate OfficerCeo Oct 1, 1992
W-2 Managing EmployeeCeo Oct 1, 1992
Edward Connors Individual Corporate DirectorBoard Member Sep 10, 2020
Corporate DirectorVice President Sep 10, 2020
Corporate OfficerVice President Sep 10, 2020
Loretta Dixon Individual Corporate OfficerVice President Mar 3, 2003
Corporate OfficerBoard Member Mar 3, 2003
Corporate DirectorVice President Mar 3, 2003
Lindsay Phillips Individual Corporate OfficerSecretary Oct 9, 2014
Corporate DirectorSecretary Oct 9, 2014
Rita Harrison Individual Corporate OfficerTreasurer Feb 8, 2018
Corporate OfficerBoard Member Feb 8, 2018
Corporate DirectorTreasurer Feb 8, 2018
Margaret Snedegar Individual Corporate DirectorBoard Member Nov 11, 2004
Tara Blevins Individual Corporate DirectorBoard Member May 1, 2021
Jeremy Faulkner Individual Corporate DirectorBoard Member Nov 14, 2013
Diana Wilson Individual Corporate DirectorTreasurer Mar 10, 2016
Corporate DirectorBoard Member Mar 10, 2016
Joan S Pugh Individual Corporate OfficerPresident Dec 1, 2005
Corporate DirectorPresident Dec 1, 2005

Practitioners & affiliated clinicians

Practitioners 94

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 94

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1457303802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411790550",
            "telephone_number": "606-796-3029",
            "fax_number": "606-796-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 KY 59",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411799719",
            "telephone_number": "606-796-3029",
            "fax_number": "606-796-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS COUNTY PRIMARY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "UGRIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-796-3029"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "KY",
            "license": "700041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0864613",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31000268",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrimaryPlus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PrimaryPlus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vanceburg, KY

Sources for this page

Verify at the official NPI Registry.