NPIMap

Organization Active NPI

Lawrenceburg Clinic Medicine

  • Family Medicine Physician
  • Lawrenceburg, KY
National Provider Identifier
1568528164
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAWRENCEBURG CLINIC MEDICINE
Practice address
504 W Broadway St
Suite B
Lawrenceburg, KY 40342-1541
Phone
(502) 839-5592
Fax
(502) 839-1041
NPI assigned
Dec 28, 2006
Last updated
May 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Authorized official

Name
Dr. Kenneth E Hines, M.D.NPI 1174516306
Title
Owner
Phone
(502) 839-5592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

504 W Broadway St
Suite B
Lawrenceburg, KY 40342-1541

Mailing address

504 W Broadway St
Suite B
Lawrenceburg, KY 40342-1541
Phone (502) 839-5592

Other identifiers 3

IdentifierTypeStateIssuer
65916165MedicaidKY
1174516306OtherKYINDIVIDUAL NPI NUMBER
4500041100OtherKYEPSDT

National Provider Directory

National Provider Directory

Locations

504 W Broadway St
Ste B
Lawrenceburg, KY 40342
Phone (502) 839-5592

Practitioners & affiliated clinicians

Practitioners 1

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": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1568528164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W BROADWAY ST",
            "address_2": "SUITE B",
            "city": "LAWRENCEBURG",
            "state": "KY",
            "postal_code": "403421541",
            "telephone_number": "502-839-5592",
            "fax_number": "502-839-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W BROADWAY ST",
            "address_2": "SUITE B",
            "city": "LAWRENCEBURG",
            "state": "KY",
            "postal_code": "403421541",
            "telephone_number": "502-839-5592",
            "fax_number": "502-839-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCEBURG CLINIC MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-839-5592",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65916165",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1174516306",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EPSDT",
            "identifier": "4500041100",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.