Individual provider Active NPI

Farrah J Conn, PA-C

  • Physician Assistant
  • Mt Sterling, KY
National Provider Identifier
1801926845
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA663 Issued in KY
Practice address
113 Autumn Ridge Dr
Mt Sterling, KY 40353-1646
Phone
(859) 585-5022
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA663 KY Primary

Addresses

Primary practice location

113 Autumn Ridge Dr
Mt Sterling, KY 40353-1646

Mailing address

113 Autumn Ridge Dr
Mt Sterling, KY 40353-1646
Phone (859) 585-5022

Other identifiers 2

IdentifierTypeStateIssuer
9500311700MedicaidKY
0693523OtherKYMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070809000603 KY Practitioner - Physician Assistant 8921199613 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA663KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Regional Physician Practices LLC CurrentSince May 1, 2015 Accepting new patients
Kentucky Hospital LLC CurrentSince Aug 1, 2013 Accepting new patients
Clark Regional Physician Practices LLC CurrentSince May 1, 2015 Accepting new patients
Kentucky Hospital, LLC CurrentSince Aug 1, 2013 Accepting new patients
Marshall Emergency Services Associates, PLLC Physician Assistant Past Accepting new patients

Locations

175 Hospital Dr
Winchester, KY 40391
Phone (859) 745-3500

225 Hospital Dr
Ste 200A
Winchester, KY 40391
Phone (859) 737-6480

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1801926845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 AUTUMN RIDGE DR",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531646",
            "telephone_number": "859-585-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 AUTUMN RIDGE DR",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531646",
            "telephone_number": "859-585-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "FARRAH",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9500311700",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0693523",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

Verify at the official NPI Registry.