Elkhorn Primary Care

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3007228 Issued in KY

Legal business name

ELKHORN PRIMARY CARE

Practice address

112 E Main St
Elkhorn City, KY 41522-9043

Phone

(606) 754-5793

Fax

(606) 886-9908

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Crystal Branham, NP

Title

Owner

Phone

(606) 754-5793

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499904000000",
    "number": "1780106591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1432",
            "city": "ELKHORN CITY",
            "state": "KY",
            "postal_code": "415229043",
            "telephone_number": "606-754-5793",
            "fax_number": "606-886-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E MAIN ST",
            "city": "ELKHORN CITY",
            "state": "KY",
            "postal_code": "415229043",
            "telephone_number": "606-754-5793",
            "fax_number": "606-886-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKHORN PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A",
        "authorized_official_last_name": "BRANHAM",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-754-5793",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100196230",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elkhorn City Post Acute LLC
• Elkhorn Dental
• Elkhorn Dental PSC
• Elkhorn Drug Inc
• Elkhorn Pharmacy LLC
• Elkhorn SNF Operations LLC
• April Robyn Fields, DO
• Cathy Nichols Francisco, RPH
• Kermit Donald Gibson, DO
• Amanda Elizabeth Griffith

• All providers in Elkhorn City, KY
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; 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.