Red Bird Clinic, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RED BIRD CLINIC, INC.

Practice address

53 Queendale Center
Suite 1
Beverly, KY 40913

Phone

(606) 598-5135

Fax

(606) 598-5131

NPI assigned

Sep 23, 2005

Organization subpart

No

Name

Kari Collins

Title

Executive Director

Phone

(606) 598-3155

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Millard Lynn Fogleman, MD

  • Family Medicine Physician
  • Beverly, KY
  • NPI 1790771046
  NPD (past)
• Sharon Kay Goodwin Fogleman, MD

  • Family Medicine Physician
  • Beverly, KY
  • NPI 1609862952
  NPD (past)
• Mary Koenen, F.N.P.

  • Family Nurse Practitioner
  • Grand Rapids, MI
  • NPI 1184777682
  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 3, 2015.

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1821084971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 QUEENDALE CENTER",
            "address_2": "SUITE 1",
            "city": "BEVERLY",
            "state": "KY",
            "postal_code": "40913",
            "telephone_number": "606-598-5135",
            "fax_number": "606-598-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 QUEENDALE CENTER",
            "address_2": "SUITE 1",
            "city": "BEVERLY",
            "state": "KY",
            "postal_code": "40913",
            "telephone_number": "606-598-5135",
            "fax_number": "606-598-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED BIRD CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "KARI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "606-598-3155"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Kay Goodwin Fogleman, MD
• Aaron N. Frye, APRN, FNP-BC
• Memorial Hospital Inc
• Memorial Hospital, Inc.
• Bruce D. Polly, RPH
• Red Bird Volunteer Fire and Rescue Inc

• All providers in Beverly, KY
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.