Main Street Clinic, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3008624 Issued in KY

Legal business name

MAIN STREET CLINIC, LLC

Practice address

900 E Main St
Cumberland, KY 40823-1714

Phone

(606) 233-1132

NPI assigned

Apr 30, 2015

Last updated

May 2, 2016By 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

Brianna Cornett, APRN-FNPNPI 1003236712

Title

Owner

Phone

(606) 233-1132

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Brianna D Cornett, NP

  • Nurse Practitioner
  • Cumberland, KY
  • NPI 1003236712
  Authorized official Same address or phone

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1477930246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320",
            "city": "CUMBERLAND",
            "state": "KY",
            "postal_code": "408230320",
            "telephone_number": "606-233-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E MAIN ST",
            "city": "CUMBERLAND",
            "state": "KY",
            "postal_code": "408231714",
            "telephone_number": "606-233-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "CORNETT",
        "authorized_official_first_name": "BRIANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-233-1132",
        "authorized_official_credential": "APRN-FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100298620",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Homer Richard Fortney, D.M.D.
• Hanging Rock LTC, LLC (Tri-Cities Nursing and Rehabilitation Center)
• Daniel E. Howard, RPH
• Billie Jo Jackson, APRN
• Christopher Lewis, APRN
• Mountain Comprehensive Health Corporation
• Johnny Richard Murphy II, PTA
• NP Caregivers, LLC
• Wendy Lynn Phillips
• Pro Health LLC

• Family Nurse Practitioner in Cumberland, KY
• Providers in Cumberland, 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 May 2, 2016; 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.