Winchester Family Practice, PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36085 Issued in KY

Legal business name

WINCHESTER FAMILY PRACTICE, PSC

Practice address

1110 McCann Dr
Suite B
Winchester, KY 40391-1157

Phone

(859) 744-1445

Fax

(859) 744-1442

NPI assigned

Jun 24, 2006

Last updated

Feb 15, 2008By 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

Amina Shalash, M.D.NPI 1528019288

Title

Owner

Phone

(859) 744-1445

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528094281. Details of each certification follow.

• CCN 183903 Rural health clinic · Active · Details

Rural health clinic certification: CCN 183903

Legal name

WINCHESTER FAMILY PRACTICE, PSC

Doing business as

N/A

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Apr 2, 2003

Last certification

Sep 22, 2015

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Jun 12, 2002 in KY

Enrollment address

4 N Highland St
Ste a
Winchester, KY 40391-2024

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23784/brand/1/csg/1/fhir/r4

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Amina Shalash, M.D.

  • Family Medicine Physician
  • Winchester, KY
  • NPI 1528019288

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 6

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.

• Amina Shalash, M.D.

  • Family Medicine Physician
  • Winchester, KY
  • NPI 1528019288
  Medicare reassignment NPD Authorized official
• Amber D Rudd, APRN

  • Nurse Practitioner
  • Winchester, KY
  • NPI 1144415746
  Medicare reassignment NPD
• Melissa Day Harris, APRN

  • Nurse Practitioner
  • Nicholasville, KY
  • NPI 1295095230
  NPD
• Richard A. Chamberlain, M.D.

  • Obstetrics & Gynecology Physician
  • Winchester, KY
  • NPI 1972547263
  NPD (past)
• Ryan Matthew Shelton, DPT

  • Physical Therapist
  • Georgetown, KY
  • NPI 1053436196
  NPD (past)
• Karen Ann Tisinai, M.D.

  • Surgery Physician
  • Terre Haute, IN
  • NPI 1396749966
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1528094281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 MCCANN DRIVE",
            "address_2": "SUITE B",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "40391",
            "telephone_number": "859-744-1445",
            "fax_number": "859-744-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 MCCANN DR",
            "address_2": "SUITE B",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911157",
            "telephone_number": "859-744-1445",
            "fax_number": "859-744-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINCHESTER FAMILY PRACTICE, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "SHALASH",
        "authorized_official_first_name": "AMINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-744-1445",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "36085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perry N Williams II, D.C.
• Sean Ronald Wilson, ATC
• Sydney Wilson
• Winchester Chiropractic Inc (Winchester Chiropractic PSC)
• Winchester Family Dentistry, PLLC
• Winchester Internal Medicine, PSC
• Winchester Medical Associates, LLC
• Winchester Medical Associates, LLC
• Winchester Neurology,PSC
• Winchester Open MRI

• Family Medicine Physician in Winchester, KY
• Providers in Winchester, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.