NPIMap

Organization Active NPI

Mountain After Hours Clinic PSC

  • Rural Health Clinic/Center
  • Hazard, KY
National Provider Identifier
1477638880
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
900091 Issued in KY
Legal business name
MOUNTAIN AFTER HOURS CLINIC PSC
Practice address
1908 N Main St
Suite 120
Hazard, KY 41701-2505
Phone
(606) 439-2662
NPI assigned
Oct 25, 2006
Last updated
Jan 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Authorized official

Name
Dr. Anthony T Yonts, DONPI 1447348388
Title
Co-Owner
Phone
(606) 436-0711

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)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 900091 KY Primary

Addresses

Primary practice location

1908 N Main St
Suite 120
Hazard, KY 41701-2505

Mailing address

1908 N Main St
Suite 120
Hazard, KY 41701-2505
Phone (606) 439-2662

Other identifiers 1

IdentifierTypeStateIssuer
7100822290MedicaidKY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030515000014 KY Part A Provider - Rural Health Clinic 0547170102 Practice locations: Hazard, KY
O20040506000973 KY Part B Supplier - Clinic/Group Practice 0547170102 Receives reassigned benefits from 73 practitioners
2 other NPIs on this enrollment
Practice locations: Hazard, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477638880. Details of each certification follow.

Rural health clinic certification: CCN 183857

Legal name
MOUNTAIN AFTER HOURS CLINIC PSC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 11, 1997
Last certification
Apr 1, 2019
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Apr 3, 1997 in KY
Enrollment address
1908 N Main St
Hazard, KY 41701

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
18D0929179Mountain After Hours Clinic1908 North Main St Ste 120, Hazard, KY 41701Certificate of waiverApr 21, 2027

National Provider Directory

National Provider Directory

Locations

1908 N Main St
Ste 120
Hazard, KY 41701
Phone 60643926622038

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIEDDD

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Brett M Muha Individual 5% Or Greater Direct Ownership Interest May 4, 2022 25%
Corporate OfficerVice President May 4, 2022 25%
Corporate DirectorVice President May 4, 2022 25%
Operational/Managerial ControlVice President May 4, 2022 25%
Anthony T Yonts Individual 5% Or Greater Direct Ownership Interest May 4, 2022 25%
Corporate OfficerPresident May 4, 2022 25%
Corporate DirectorPresident May 4, 2022 25%
W-2 Managing EmployeePresident May 4, 2022 25%
Operational/Managerial ControlPresident May 4, 2022 25%
Michael W Raichel Individual 5% Or Greater Direct Ownership Interest May 4, 2022 25%
Corporate OfficerSecretary May 4, 2022 25%
Corporate DirectorSecretary May 4, 2022 25%
Operational/Managerial ControlSecretary May 4, 2022 25%
Darian K Ratliff Individual 5% Or Greater Direct Ownership Interest May 4, 2022 25%
Corporate OfficerTreasurer May 4, 2022 25%
Corporate DirectorTreasurer May 4, 2022 25%
Operational/Managerial ControlTreasurer May 4, 2022 25%

Owners & managing parties with NPI records 4

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

  • Brett Muha, MD
    • Family Medicine Physician
    • Hazard, KY
    • NPI 1174547210

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control

    CMS ownership
  • Michael Raichel, DO
    • Family Medicine Physician
    • Hazard, KY
    • NPI 1932270006

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control

    CMS ownership
  • Darian Ratliff, MD
    • Internal Medicine Physician
    • Hazard, KY
    • NPI 1760484216

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control

    CMS ownership
  • Anthony Yonts, DO
    • Pediatrics Physician
    • Hazard, KY
    • NPI 1447348388

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 73

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 73

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1477638880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 N MAIN ST",
            "address_2": "SUITE 120",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012505",
            "telephone_number": "606-439-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 N MAIN ST",
            "address_2": "SUITE 120",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012505",
            "telephone_number": "606-439-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN AFTER HOURS CLINIC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "YONTS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "606-436-0711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "900091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100822290",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.