NPIMap

Organization Active NPI

Laurel Medical Services LLC

  • Rural Health Clinic/Center
  • London, KY
National Provider Identifier
1720819980
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LAUREL MEDICAL SERVICES LLC
Practice address
421 W Highway 80
London, KY 40741-1070
Phone
(606) 657-2345
NPI assigned
Aug 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
Keisha Shae PerkinsNPI 1548896335
Title
Owner
Phone
(606) 657-2345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

421 W Highway 80
London, KY 40741-1070

Mailing address

421 W Highway 80
London, KY 40741-1070
Phone (606) 657-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240913001464 KY Part A Provider - Rural Health Clinic 9638530785 Practice locations: London, KY

Rural health clinic certification: CCN B03969

Legal name
LAUREL MEDICAL SERVICES LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 20, 2024
Last certification
Nov 20, 2024
Ownership / control type
1A
Organization structure
LLCProprietary
Incorporated
May 27, 2016 in KY
Enrollment address
421 W Highway 80
London, KY 40741-1070

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Laurel Medical Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

421 W Highway 80
London, KY 40741
Phone (606) 657-2345

Ownership & related parties

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.

NameRoleSinceShare
Keisha Perkins Individual 5% Or Greater Direct Ownership InterestOwner May 27, 2016 100%
W-2 Managing EmployeeAd; May 27, 2016 100%
Operational/Managerial ControlAdministrator May 27, 2016 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1720819980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W HIGHWAY 80",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411070",
            "telephone_number": "606-657-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W HIGHWAY 80",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411070",
            "telephone_number": "606-657-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_middle_name": "SHAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-657-2345"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.