NPIMap

Organization Active NPI

Frontier Medical Associates of Paintsville Inc

  • Rural Health Clinic/Center
  • Paintsville, KY
National Provider Identifier
1568070142
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FRONTIER MEDICAL ASSOCIATES OF PAINTSVILLE INC
Practice address
713 Broadway St Ste 301B
Paintsville, KY 41240-1465
Phone
(606) 372-1234
Fax
(606) 372-1240
NPI assigned
Jul 20, 2020
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Antoin Hana, MDNPI 1669483830
Title
MD
Phone
(606) 372-1234

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X NU
Internal Medicine Physician 207R00000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

713 Broadway St Ste 301B
Paintsville, KY 41240-1465

Mailing address

PO Box 280
Prestonsburg, KY 41653-0280
Phone (606) 372-1234

Other identifiers 5

IdentifierTypeStateIssuer
7100690030MedicaidKY
7100690460MedicaidKY
7100690060MedicaidKY
7100689940MedicaidKY
7100690430MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahowell@frontiermedical.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200916002859 KY Part B Supplier - Clinic/Group Practice 2961820337 Receives reassigned benefits from 40 practitioners
Practice locations: Paintsville, KY
O20201005002782 KY Part A Provider - Rural Health Clinic 2961820337 Practice locations: Paintsville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568070142. Details of each certification follow.

Rural health clinic certification: CCN B03831

Legal name
FRONTIER MEDICAL ASSOCIATES OF PAINTSVILLE INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 4, 2021
Last certification
Mar 4, 2021
Ownership / control type
1A
Organization structure
CorporationProprietary
Incorporated
Jul 16, 2020 in KY
Enrollment address
713 Broadway St
Ste 301
Paintsville, KY 41240-1613

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2189923Frontier Medical Associates of Paintsville713 Broadway Street Suite 301, Paintsville, KY 41240ComplianceNov 20, 2026

National Provider Directory

National Provider Directory

Locations

713 Broadway St
Ste 301
Paintsville, KY 41240
Phone (606) 372-1234

713 Broadway St
Ste 301B
Paintsville, KY 41240
Phone (606) 372-1234

Ownership & related parties

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.

NameRoleSinceShare
Antoin Hana Individual 5% Or Greater Direct Ownership InterestMD Aug 1, 2020 100%
Corporate OfficerCeo Aug 1, 2020 100%
Corporate DirectorMedical Director Aug 1, 2020 100%
W-2 Managing EmployeeMD Aug 1, 2020 100%

Owners & managing parties with NPI records 1

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

  • Antoin Hana, M.D.
    • Pediatrics Physician
    • Prestonsburg, KY
    • NPI 1669483830

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

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1568070142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416530280",
            "telephone_number": "606-372-1234",
            "fax_number": "606-372-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 BROADWAY ST STE 301B",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401465",
            "telephone_number": "606-372-1234",
            "fax_number": "606-372-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER MEDICAL ASSOCIATES OF PAINTSVILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-20",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-21",
        "status": "A",
        "authorized_official_last_name": "HANA",
        "authorized_official_first_name": "ANTOIN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "606-372-1234",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100690030",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100690460",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100690060",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100689940",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100690430",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahowell@frontiermedical.org",
            "affiliation": "N",
            "endpointDescription": "Secure Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "713 Broadway St",
            "city": "Paintsville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "412401465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paintsville, KY

Sources for this page

Verify at the official NPI Registry.