Marshall County Family Medical Center Nurse Practitioner Group

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4072P Issued in KY

Legal business name

MARSHALL COUNTY FAMILY MEDICAL CENTER NURSE PRACTITIONER GROUP

Practice address

145 Vine St # 569
Benton, KY 42025-7472

Phone

(270) 527-2273

NPI assigned

Dec 7, 2007

Last updated

Dec 7, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

MARSHALL COUNTY FAMILY MEDICALAs reported in NPPES

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

Authorized official

Name

Marsha R Tucker

Title

Office Manager

Phone

(270) 527-2273

Specialties & licenses 1

Addresses

Other identifiers 4

Tax ID family

Marshall County Medical Associates2 organizations share this tax ID, including this one

Part of

Marshall County Medical Associates

Other organizations with this tax ID 1

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

• Marshall County Medical Associates

  • Family Medicine Physician
  • Benton, KY
  • NPI 1477605988
  NPD tax ID

Locations

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1659554079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 VINE ST",
            "address_2": "PO BOX 569",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257472",
            "telephone_number": "270-527-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 VINE ST # 569",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257472",
            "telephone_number": "270-527-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL COUNTY FAMILY MEDICAL CENTER NURSE PRACTITIONER GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARSHALL COUNTY FAMILY MEDICAL",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-527-2273"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4072P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1891878641",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1689710899",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1619907870",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78900180",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natasha G. Lyles, O.D.
• Amber Manning, PHARM.D
• Marshall County Anesthesia
• Marshall County Anesthesia PLLC
• Marshall County Assn. for Exceptional Children and Adults, Inc
• Marshall County Health Department (North Marshall Middle School)
• Marshall County Health Dept (Benton Elementary School)
• Marshall County Health Dept (Marshall County High School)
• Marshall County Health Dept
• Marshall County Health Dept (South Marshall Elementary School)

• Family Nurse Practitioner in Benton, KY
• Providers in Benton, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.