Bellefonte Physician Services, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BELLEFONTE PHYSICIAN SERVICES, INC.

Doing business as

Bellefonte Primary Care, South Shore

Practice address

US 23 at Indianola Ave.
South Shore, KY 41175

Phone

(606) 932-3150

NPI assigned

Nov 21, 2008

Last updated

May 20, 2019By 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

Troy Connett

Title

Director of Finance

Phone

(606) 833-3333

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 1

• Bellefonte Primary Care, South Shore Doing business as

Practitioners 2

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.

• Michele A Friday, MD

  • Cardiovascular Disease Physician
  • Russell, KY
  • NPI 1750359857
  NPD (past)
• Glendese Camille Miller, MD

  • Internal Medicine Physician
  • West Palm Beach, FL
  • NPI 1902906373
  NPD (past)

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1740435445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2155",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052155",
            "telephone_number": "606-932-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US 23 AT INDIANOLA AVE.",
            "city": "SOUTH SHORE",
            "state": "KY",
            "postal_code": "41175",
            "telephone_number": "606-932-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEFONTE PHYSICIAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-21",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "CONNETT",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "606-833-3333"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2914921",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7920801",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DN8303",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000598137",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100068960",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellefonte Primary Care, South Shore",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bellefonte Primary Care, South Shore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in South Shore, KY
• Providers in South Shore, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.