Communtiy Healthcare of Western Kentucky LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

COMMUNTIY HEALTHCARE OF WESTERN KENTUCKY LLC

Practice address

308 South Washington Street Suite 200
Clinton, KY 42031

Phone

(270) 653-0220

Fax

(270) 653-0221

NPI assigned

Sep 4, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Stephannie Lorene Goodrum, RN

Title

Owner

Phone

(270) 653-0220

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Bruce C Smith, M.D.

  • Family Medicine Physician
  • Clinton, KY
  • NPI 1962400648
  NPD (past)

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

{
    "created_epoch": "1504483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780102301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 SOUTH WASHINGTON STREET SUITE 200",
            "city": "CLINTON",
            "state": "KY",
            "postal_code": "420311347",
            "telephone_number": "270-653-0220",
            "fax_number": "270-653-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 SOUTH WASHINGTON STREET SUITE 200",
            "city": "CLINTON",
            "state": "KY",
            "postal_code": "42031",
            "telephone_number": "270-653-0220",
            "fax_number": "270-653-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNTIY HEALTHCARE OF WESTERN KENTUCKY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GOODRUM",
        "authorized_official_first_name": "STEPHANNIE",
        "authorized_official_middle_name": "LORENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-653-0220",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100237310",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760722144",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clinton and Hickman County Hospital, Inc.
• Clinton Dental Clinic,Inc.
• Clinton Pharmacy LLC
• Clinton Pharmacy LLC
• Clinton-Hickman County Ambulance Service Inc
• Diversicare Clinton, LLC
• Giaimo Mobile Podiatry PLLC
• Stephannie Lorene Goodrum, APRN
• Whitney Nicole Gordon
• Gretchen Anne Hayden, DOCTOR OF PHARMACY

• All providers in Clinton, KY
• Primary Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.