NPIMap

Organization Active NPI

Family Medical Care of Manchester

  • Family Medicine Physician
  • Manchester, KY
National Provider Identifier
1700827599
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38637 Issued in KY
Legal business name
FAMILY MEDICAL CARE OF MANCHESTER
Practice address
94 Marie Langdon Dr
Suite 1
Manchester, KY 40962-6353
Phone
(606) 599-9955
Fax
(606) 599-9966
NPI assigned
Jun 10, 2006
Last updated
Jul 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Dr. Douglas Gerardy Irwin, M.D.NPI 1538115621
Title
Owner
Phone
(606) 599-9955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38637 KY Primary

Addresses

Primary practice location

94 Marie Langdon Dr
Suite 1
Manchester, KY 40962-6353

Mailing address

94 Marie Langdon Dr
Suite 1
Manchester, KY 40962-6353
Phone (606) 599-9955

Other identifiers 5

IdentifierTypeStateIssuer
31000813MedicaidKY
000000195439OtherKYBLUE CROSS/BLUE SHIELD
1168920OtherKYPASSPORT GROUP PROVIDER #
020252900OtherKYBLACK LUNG GROUP #
C92418OtherKYCUMBERLAND HEALTHCARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1700827599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 MARIE LANGDON DR",
            "address_2": "SUITE 1",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626353",
            "telephone_number": "606-599-9955",
            "fax_number": "606-599-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 MARIE LANGDON DR",
            "address_2": "SUITE 1",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626353",
            "telephone_number": "606-599-9955",
            "fax_number": "606-599-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CARE OF MANCHESTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "IRWIN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "GERARDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-599-9955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "38637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31000813",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000195439",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT GROUP PROVIDER #",
            "identifier": "1168920",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG GROUP #",
            "identifier": "020252900",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CUMBERLAND HEALTHCARE",
            "identifier": "C92418",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.