NPIMap

Organization Active NPI

Kentucky Hospital, LLC

Doing business as Clark Immediate Care Center

  • Primary Care Clinic/Center
  • Winchester, KY
National Provider Identifier
1528385226
Registry record updated Mar 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
KENTUCKY HOSPITAL, LLC
Doing business as
Clark Immediate Care Center
Practice address
1934 Bypass Rd
Winchester, KY 40391-2389
Phone
(859) 745-1160
Fax
(859) 745-7789
NPI assigned
Apr 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2014

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

Authorized official

Name
Robert Scott Raplee
Title
President
Phone
(615) 920-7000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1934 Bypass Rd
Winchester, KY 40391-2389

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-4536
Phone (615) 920-7000

Other names 1

  • Clark Immediate Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100811000003 KY Part B Supplier - Clinic/Group Practice 4688614290 Receives reassigned benefits from 15 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winchester, KY; Stanton, KY

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395532800000",
    "number": "1528385226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274536",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 BYPASS RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403912389",
            "telephone_number": "859-745-1160",
            "fax_number": "859-745-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-21",
        "last_updated": "2014-03-23",
        "status": "A",
        "authorized_official_last_name": "RAPLEE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Immediate Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2014; 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.