NPIMap

Organization Active NPI

McCreary Primary Care Center, Inc

  • Rural Health Clinic/Center
  • Whitley City, KY
National Provider Identifier
1497938583
Registry record updated Nov 24, 2014
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Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MCCREARY PRIMARY CARE CENTER, INC
Practice address
65 Center Ave
Whitley City, KY 42653-0000
Phone
(606) 376-2224
Fax
(606) 376-2205
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Authorized official

Name
Mr. Kenneth E Allison
Title
President
Phone
(859) 578-4822

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 02506 KY
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

65 Center Ave
Whitley City, KY 42653-0000

Mailing address

PO Box 129
Whitley City, KY 42653-0000
Phone (606) 376-2224

Other identifiers 3

IdentifierTypeStateIssuer
7100029190MedicaidKY
7100300430MedicaidKY
000000597415OtherKYANTHEM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1497938583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "WHITLEY CITY",
            "state": "KY",
            "postal_code": "426530000",
            "telephone_number": "606-376-2224",
            "fax_number": "606-376-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CENTER AVE",
            "city": "WHITLEY CITY",
            "state": "KY",
            "postal_code": "426530000",
            "telephone_number": "606-376-2224",
            "fax_number": "606-376-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCREARY PRIMARY CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-578-4822",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "02506",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100029190",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100300430",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000597415",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitley City, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.