Main Street Family Medicine, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2848P Issued in KY

Legal business name

MAIN STREET FAMILY MEDICINE, LLC

Practice address

10015 Main St
Whitesville, KY 42378-9557

Phone

(270) 233-1884

Fax

(270) 233-9520

NPI assigned

Jul 2, 2006

Last updated

Mar 21, 2022By 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

Cynthia Dianne Glenn-Birkhead, ARNPNPI 1598720625

Title

Owner

Phone

(270) 233-1884

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

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

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.

• Cynthia Diane Glenn-Birkhead, ARNP

  • Family Nurse Practitioner
  • Whitesville, KY
  • NPI 1598720625
  Medicare reassignment NPD Authorized official
• Kristin P. Boothe, APRN

  • Family Nurse Practitioner
  • Owensboro, KY
  • NPI 1902118789
  Medicare reassignment NPD
• Tamara Kay Rhodes, NP,AGACNP

  • Nurse Practitioner
  • Whitesville, KY
  • NPI 1306452867
  Medicare reassignment NPD
• Judy G Bandy, FNP

  • Family Nurse Practitioner
  • Prescott, AZ
  • NPI 1922022086

  KY

  Medicare reassignment NPD
• Kimberley Elaine Gillians, APRN

  • Family Nurse Practitioner
  • Newburgh, IN
  • NPI 1366927667

  KY

  Medicare reassignment NPD
• Julie Anne Salisbury, PA-C

  • Physician Assistant
  • Owensboro, KY
  • NPI 1831124908
  Medicare reassignment

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647820800000",
    "number": "1528097433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10015 MAIN ST",
            "city": "WHITESVILLE",
            "state": "KY",
            "postal_code": "423789557",
            "telephone_number": "270-233-1884",
            "fax_number": "270-233-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10015 MAIN ST",
            "city": "WHITESVILLE",
            "state": "KY",
            "postal_code": "423789557",
            "telephone_number": "270-233-1884",
            "fax_number": "270-233-9520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2429 W Parrish Ave # 3",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423012661",
            "country_code": "US",
            "telephone_number": "270-215-0325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAIN STREET FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A",
        "authorized_official_last_name": "GLENN-BIRKHEAD",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "DIANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-233-1884",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "2848P",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duvall Child Development Center, LLC
• Cynthia Diane Glenn-Birkhead, ARNP
• Emma Grant
• Jamie Michelle Hamilton, M.S., CFY-SLP
• Kentucky Orthopedic Rehabilitation, LLC (KORT Whitesville)
• Stephanie Ann Millay
• Non Emergency Medical Transportation of Kentucky
• Deborah G Rhodes, LMT
• Tamara Kay Rhodes, NP,AGACNP
• Shanon L. Stamper, LPCC

• Family Nurse Practitioner in Whitesville, KY
• Providers in Whitesville, 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 Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.