Liberty Medical Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3004478 Issued in KY

Legal business name

LIBERTY MEDICAL CLINIC

Practice address

108 Taylor St
Liberty, KY 42539-3160

Phone

(606) 706-4265

Fax

(606) 706-4275

NPI assigned

Apr 20, 2011

Last updated

Oct 29, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vickie L Marple, APRN-FNPI 1447281712

Title

Nurse Practitioner/Owner

Phone

(606) 706-4265

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Vickie L Marple, ARNP

  • Nurse Practitioner
  • Liberty, KY
  • NPI 1447281712
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1477844835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 TAYLOR ST",
            "address_2": "P.O. BOX 1196",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393160",
            "telephone_number": "606-706-4265",
            "fax_number": "606-706-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 TAYLOR ST",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393160",
            "telephone_number": "606-706-4265",
            "fax_number": "606-706-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-20",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "MARPLE",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "606-706-4265",
        "authorized_official_credential": "APRN-F"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3004478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447281712",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7815765",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Cumberland District Health Dept. (Jones Park Elementary School)
• Lake Cumberland District Health Dept. (Casey County High School)
• Molly Ledford
• Emily Salome Lemmon
• Liberty Drug Inc
• Karen Faye Likins, APRN
• LP Liberty, LLC (Liberty Care & Rehabilitation Center)
• Kimberly Luttrell, AGPCNP
• David Michael Lutz
• Kyle Brent Mann, DMD

• Family Nurse Practitioner in Liberty, KY
• Providers in Liberty, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.