NPIMap

Individual provider Active NPI

June Elizabeth Abadilla

  • Internal Medicine Physician
  • Jackson, KY
National Provider Identifier
1811975683
Registry record updated Sep 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38443 Issued in KY
Practice address
12 Jackson HTS
Jackson, KY 41339
Phone
(606) 666-7040
Fax
(606) 666-9480
NPI assigned
Jan 3, 2006
Last updated
Sep 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38443 KY Primary

Addresses

Primary practice location

12 Jackson HTS
Jackson, KY 41339

Mailing address

12 Jackson HTS
Jackson, KY 41339-6500
Phone (606) 693-0199

Other identifiers 1

IdentifierTypeStateIssuer
64087588MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506000617 KY Practitioner - Internal MedicinePractitioner - Pulmonary Disease 4385632371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medical Specialty Clinic PLLCGroup PAC ID 0941102305, 2 clinicians

Practice addresses (Care Compare)

12 Jackson HTS
Jackson, KY 41339-6500
Phone (606) 693-0199

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Specialty Clinic D.B.a. Internal Medicine Current Accepting new patients
Family Medical Specialty Clinic PLLC Internal Medicine CurrentSince Jul 28, 2003 Accepting new patients

Locations

12 Jackson Hts
Jackson, KY 41339
Phone (606) 693-0199

4 Jackson Hts
Jackson, KY 41339
Phone (606) 666-7040

95 Jackson Hts
Jackson, KY 41339
Phone (606) 666-7040

Interoperability endpoints

  • Direct secure messaging: jmmccagg@yourcarecommunity.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Medical Specialty Clinic PLLCJackson, KY, CCN B03881 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer
Operational/Managerial Control		 Jul 28, 2003
Jul 28, 2003
Jul 28, 2003

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664064000000",
    "number": "1811975683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 JACKSON HTS",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413396500",
            "telephone_number": "606-693-0199",
            "fax_number": "606-666-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 JACKSON HTS",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "41339",
            "telephone_number": "606-666-7040",
            "fax_number": "606-666-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABADILLA",
        "first_name": "JUNE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2022-09-25",
        "certification_date": "2022-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "38443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64087588",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, KY

Sources for this page

Verify at the official NPI Registry.