NPIMap

Organization Active NPI

Bell Clinic PLLC

  • Family Medicine Physician
  • Elkton, KY
National Provider Identifier
1790935997
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BELL CLINIC PLLC
Practice address
105 Elk Fork Rd
Elkton, KY 42220-0000
Phone
(270) 265-2575
Fax
(270) 265-3098
NPI assigned
Sep 24, 2008
Last updated
Aug 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Authorized official

Name
Geeta Chavda, M.D.NPI 1962477133
Title
Owner
Phone
(270) 265-2575

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X KY Primary

Addresses

Primary practice location

105 Elk Fork Rd
Elkton, KY 42220-0000

Mailing address

PO Box 187
Elkton, KY 42220-0187
Phone (270) 265-2575

Other identifiers 2

IdentifierTypeStateIssuer
00819OtherKYMEDICARE PTAN
18D0953137OtherKYCLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081219000073 KY Part B Supplier - Clinic/Group Practice 1153483581 Receives reassigned benefits from 13 practitioners
Practice locations: Elkton, KY
O20090105000009 KY Part A Provider - Rural Health Clinic 1153483581 Practice locations: Elkton, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790935997. Details of each certification follow.

Rural health clinic certification: CCN 183859

Legal name
BELL CLINIC PLLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 1, 1998
Last certification
Dec 6, 2017
Ownership / control type
1B
Most recent change of ownership
Jan 1, 2009 (4 total)
Organization structure
LLCProprietary
Incorporated
Oct 17, 2008 in KY
Enrollment address
105 Elk Fork Road
Elkton, KY 42220-7218

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0953137Bell Clinic, PLLC105 Elk Fork Road, Elkton, KY 42220Provider-performed microscopyOct 26, 2026

National Provider Directory

National Provider Directory
Tax ID family
Bell Clinic2 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

105 Elk Fork Rd
Elkton, KY 42220
Phone (270) 265-2574

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Latisha Edmonds Individual W-2 Managing EmployeeAdministrator Jun 1, 2013
Geeta S Chavda Individual 5% Or Greater Direct Ownership Interest Oct 17, 2008 100%
Corporate DirectorMedical Director Oct 17, 2008

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 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1790935997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "ELKTON",
            "state": "KY",
            "postal_code": "422200187",
            "telephone_number": "270-265-2575",
            "fax_number": "270-265-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ELK FORK RD",
            "city": "ELKTON",
            "state": "KY",
            "postal_code": "422200000",
            "telephone_number": "270-265-2575",
            "fax_number": "270-265-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "CHAVDA",
        "authorized_official_first_name": "GEETA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-265-2575",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00819",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "18D0953137",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, KY

Sources for this page

Verify at the official NPI Registry.