NPIMap

Organization Active NPI

Community Care of Kentucky, Inc.

  • General Practice Dentistry
  • Madisonville, KY
National Provider Identifier
1588056519
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMMUNITY CARE OF KENTUCKY, INC.
Practice address
200 Clinic Dr
Madisonville, KY 42431-1661
Phone
(270) 681-0514
Fax
(270) 681-5315
NPI assigned
Feb 27, 2015
Last updated
Feb 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Authorized official

Name
Mrs. Marlen Whitmore, B.S.
Title
Credentialing Manager
Phone
(256) 241-3965

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

200 Clinic Dr
Madisonville, KY 42431-1661

Mailing address

PO Box 2369
Anniston, AL 36202-2369
Phone (256) 241-3965

National Provider Directory

National Provider Directory
Tax ID family
Community Care of Kentucky Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424995200000",
    "number": "1588056519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2369",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362022369",
            "telephone_number": "256-241-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-681-0514",
            "fax_number": "270-681-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE OF KENTUCKY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-27",
        "last_updated": "2015-02-27",
        "status": "A",
        "authorized_official_last_name": "WHITMORE",
        "authorized_official_first_name": "MARLEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "256-241-3965",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.