NPIMap

Organization Active NPI

Independence Urgent Care LLC

  • Urgent Care Clinic/Center
  • Independence, KY
National Provider Identifier
1508000951
Registry record updated Apr 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
0726566 Issued in KY
Legal business name
INDEPENDENCE URGENT CARE LLC
Practice address
2025 Declaration Drive
Independence, KY 41051
Phone
(859) 363-3330
NPI assigned
Apr 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2010

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

Authorized official

Name
Bashar Brijawi, MD
Title
Medical Director
Phone
(859) 363-3330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 0726566 KY Primary

Addresses

Primary practice location

2025 Declaration Drive
Independence, KY 41051

Mailing address

2025 Declaration Drive
Independence, KY 41051
Phone (859) 363-3330

Other identifiers 1

IdentifierTypeStateIssuer
7100091380MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270598400000",
    "number": "1508000951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 DECLARATION DRIVE",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "41051",
            "telephone_number": "859-363-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 DECLARATION DRIVE",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "41051",
            "telephone_number": "859-363-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2010-04-07",
        "status": "A",
        "authorized_official_last_name": "BRIJAWI",
        "authorized_official_first_name": "BASHAR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "859-363-3330",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "KY",
            "license": "0726566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100091380",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; 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.