Clark Regional Medical Center

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

100073 Issued in KY

Legal business name

CLARK REGIONAL MEDICAL CENTER

Practice address

1107 W Lexington Ave
Winchester, KY 40391-1169

Phone

(859) 745-3500

Fax

(859) 745-3450

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert Donald Fraraccio

Title

Ceo

Phone

(859) 745-3500

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://fhir.yourcareuniverse.net/tenant/5b55bbf3-16df-4568-b6d2-21144fc38584

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1619156403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 W LEXINGTON AVE",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911169",
            "telephone_number": "859-745-3500",
            "fax_number": "859-745-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 W LEXINGTON AVE",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911169",
            "telephone_number": "859-745-3500",
            "fax_number": "859-745-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "FRARACCIO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-745-3500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "KY",
            "license": "100073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45004199",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark Family Care
• Clark Infusion Group LLC
• Clark Medical Ventures, LLC
• Clark Pharmacists Group PLLC
• Clark Radiology, PLLC
• Clark Regional Medical Center, Inc
• Clark Regional Medical Center, Inc
• Clark Regional Medical Center, Inc
• Clark Regional Medical Center, Inc
• Clark Regional Medical Center, Inc.

• Pediatric Occupational Therapist in Winchester, KY
• Providers in Winchester, KY by specialty
• Pediatric Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.