NPIMap

Organization Active NPI

Barbourville Family Health Center

  • Rural Health Clinic/Center
  • Barbourville, KY
National Provider Identifier
1801872882
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BARBOURVILLE FAMILY HEALTH CENTER
Practice address
215 N Allison Ave
Barbourville, KY 40906-1336
Phone
(606) 546-9287
Fax
(606) 546-9363
NPI assigned
Dec 21, 2005
Last updated
Sep 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Stephanie Wilson
Title
Practice Manager
Phone
(606) 546-9287

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

215 N Allison Ave
Barbourville, KY 40906-1336

Mailing address

PO Box 1150
Barbourville, KY 40906-5150
Phone (606) 546-9287

Other identifiers 1

IdentifierTypeStateIssuer
7100157240MedicaidKY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040702000050 KY Part B Supplier - Clinic/Group Practice 7416867387 Receives reassigned benefits from 33 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Barbourville, KY; Corbin, KY
O20101123001134 KY Part A Provider - Rural Health Clinic 7416867387 Practice locations: Barbourville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801872882. Details of each certification follow.

Rural health clinic certification: CCN 183916

Legal name
BARBOURVILLE FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 8, 2003
Last certification
Jul 26, 2017
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jun 23, 1986 in KY
Enrollment address
215 N Allison Avenue
Barbourville, KY 40906-1336

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
18D0700983Barbourville Family Health Center215 N Allison Avenue PO Box 1150, Barbourville, KY 40906Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

315 Hospital Dr
Barbourville, KY 40906
Phone (606) 277-2999

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
Richard a Carter Individual 5% Or Greater Direct Ownership Interest Oct 3, 2006 100%
Corporate OfficerCeo/Owner Oct 4, 2006 100%
Corporate DirectorCeo/Owner Oct 4, 2006
W-2 Managing EmployeeCeo/Owner Oct 4, 2006
Stephanie Wilson Individual Operational/Managerial Control Jun 9, 2015

Owners & managing parties with NPI records 1

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

  • Richard A Carter, MD
    • Family Medicine Physician
    • Barbourville, KY
    • NPI 1639155575

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1801872882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1150",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409065150",
            "telephone_number": "606-546-9287",
            "fax_number": "606-546-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N ALLISON AVE",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061336",
            "telephone_number": "606-546-9287",
            "fax_number": "606-546-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARBOURVILLE FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-21",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "606-546-9287"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100157240",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barbourville, KY

Sources for this page

Verify at the official NPI Registry.