Individual provider Active NPI

Laura Clifton, PA-C

  • Physician Assistant
  • Corbin, KY
National Provider Identifier
1649219767
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA331 Issued in KY
Practice address
1 Trillium Way
Corbin, KY 40701-8426
Phone
(606) 528-1212
NPI assigned
Jun 5, 2006
Last updated
Jul 23, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA331 KY Primary

Addresses

Primary practice location

1 Trillium Way
Corbin, KY 40701-8426

Mailing address

1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984

Other identifiers 1

IdentifierTypeStateIssuer
P00292507OtherKYRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000871 KY Practitioner - Physician Assistant 1052326337 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Medical Group of Kentucky PLLCGroup PAC ID 9133483894, 78 clinicians

Practice addresses (Care Compare)

210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone (606) 598-5104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA331KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group of Kentucky PLLC CurrentSince Dec 3, 2025 Accepting new patients
Green Valley Emergency Physicians, LLC Physician Assistant CurrentSince Feb 12, 2026 Accepting new patients

Locations

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1649219767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 CENTERPOINT BLVD",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TRILLIUM WAY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018426",
            "telephone_number": "606-528-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "LAURA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00292507",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.