NPIMap

Organization Active NPI

Leitchfield Primary Care PLLC

  • Family Medicine Physician
  • Tell City, IN
National Provider Identifier
1508117334
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LEITCHFIELD PRIMARY CARE PLLC
Practice address
8885 State Road 237
Tell City, IN 47586-8567
Phone
(812) 547-7011
NPI assigned
Sep 19, 2012
Last updated
Aug 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Andrew W Jenkins, MDNPI 1144491598
Title
Sole Member
Phone
(270) 744-9600

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

8885 State Road 237
Tell City, IN 47586-8567

Mailing address

PO Box 9150
Paducah, KY 42002-9150
Phone (270) 744-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130401000505 KY Part B Supplier - Clinic/Group Practice 7012152648 Receives reassigned benefits from 1 practitioner
Practice locations: Hardinsburg, KY
O20230223002134 IN Part B Supplier - Clinic/Group Practice 7012152648 Receives reassigned benefits from 1 practitioner
Practice locations: Tell City, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1508117334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8885 STATE ROAD 237",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475868567",
            "telephone_number": "812-547-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEITCHFIELD PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "270-744-9600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tell City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.