NPIMap

Organization Active NPI

Bluegrass Clinic Liberty, PLLC

  • Family Medicine Physician
  • Liberty, KY
National Provider Identifier
1457555146
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BLUEGRASS CLINIC LIBERTY, PLLC
Practice address
256 N Wallace Wilkinson Blvd
Liberty, KY 42539-3014
Phone
(160) 678-7001
Fax
(606) 787-0035
NPI assigned
Jun 14, 2007
Last updated
Oct 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Dr. James A Miller, M.D.
Title
Provider Owner
Phone
(606) 365-8338

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

256 N Wallace Wilkinson Blvd
Liberty, KY 42539-3014

Mailing address

256 N Wallace Wilkinson Blvd
Liberty, KY 42539-3014
Phone (606) 787-0014

National Provider Directory

National Provider Directory

Locations

19 Abes Plz
Liberty, KY 42539
Phone 6063658338312

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1457555146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 N WALLACE WILKINSON BLVD",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393014",
            "telephone_number": "606-787-0014",
            "fax_number": "606-787-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 N WALLACE WILKINSON BLVD",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393014",
            "telephone_number": "160-678-7001",
            "fax_number": "606-787-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS CLINIC LIBERTY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROVIDER OWNER",
        "authorized_official_telephone_number": "606-365-8338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.