Community Family Clinic-School LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

COMMUNITY FAMILY CLINIC-SCHOOL LLC

Practice address

359 Wynn Flat Rd RM 121
Frenchburg, KY 40322-7807

Phone

(606) 768-9190

Fax

(606) 768-9180

NPI assigned

Jul 18, 2023

Last updated

Feb 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Taufik Kassis, MDNPI 1174545628

Title

Owner/Physician

Phone

(606) 768-9190

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639858467. Details of each certification follow.

• CCN B03943 Rural health clinic · Active · Details

Rural health clinic certification: CCN B03943

Legal name

COMMUNITY FAMILY CLINIC-SCHOOL LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Jan 5, 2024

Last certification

Jan 5, 2024

Ownership / control type

1B

Organization structure

LLCProprietary

Incorporated

May 25, 2023 in KY

Enrollment address

359 Wynn Flat Rd
RM 121
Frenchburg, KY 40322-7807

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

CLIA laboratory certificates

Locations

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.

Owners & managing parties with NPI records 1

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

• Taufik Kassis, MD

  • Internal Medicine Physician
  • Frenchburg, KY
  • NPI 1174545628

  5% Or Greater Direct Ownership Interest, Corporate Director, Operational/Managerial Control

  CMS ownership

Practitioners 5

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.

• Taufik Kassis, MD

  • Internal Medicine Physician
  • Frenchburg, KY
  • NPI 1174545628
  NPD (past) Authorized official
• Karen Metler, APRN

  • Family Nurse Practitioner
  • Frenchburg, KY
  • NPI 1558726018
  NPD
• Amy Back Brown, APRN

  • Family Nurse Practitioner
  • Frenchburg, KY
  • NPI 1558818401
  NPD (past)
• Hannah Toy Dunaway, APRN

  • Family Nurse Practitioner
  • Frenchburg, KY
  • NPI 1942605050
  NPD (past)
• Lisa Ann Goldstein, MD

  • Family Medicine Physician
  • Frenchburg, KY
  • NPI 1912128430
  NPD (past)

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1639858467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 855",
            "city": "FRENCHBURG",
            "state": "KY",
            "postal_code": "403220855",
            "telephone_number": "606-768-9190",
            "fax_number": "606-768-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 WYNN FLAT RD RM 121",
            "city": "FRENCHBURG",
            "state": "KY",
            "postal_code": "403227807",
            "telephone_number": "606-768-9190",
            "fax_number": "606-768-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY FAMILY CLINIC-SCHOOL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "KASSIS",
        "authorized_official_first_name": "TAUFIK",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "606-768-9190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatiana Cardoso, M.D.
• Rhea Caudill, LMFT
• William Chapman
• Jennifer Richards Clark, APRN
• Community Family Clinic PLLC
• Morgan Craft
• Phyllis Crockett
• Leanna Daniel, CSW
• Sherees C Darnell, LCSW
• Bradley J Davidson, PT

• Rural Health Clinic/Center in Frenchburg, KY
• Providers in Frenchburg, KY by specialty
• Rural Health Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.