Eastern Ky Tender Care Pediatrics, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

EASTERN KY TENDER CARE PEDIATRICS, LLC

Practice address

5000 Ky Route 321
Suite 3141
Prestonsburg, KY 41653-9113

Phone

(606) 886-7517

Fax

(606) 886-7524

NPI assigned

Aug 9, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Antoin Hana, M.D.NPI 1669483830

Title

Owner

Phone

(606) 886-7517

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Antoin Hana, M.D.

  • Pediatrics Physician
  • Prestonsburg, KY
  • NPI 1669483830
  NPD (past) Authorized official

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831190115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 697",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416530697",
            "telephone_number": "606-886-7517",
            "fax_number": "606-886-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 KY ROUTE 321",
            "address_2": "SUITE 3141",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416539113",
            "telephone_number": "606-886-7517",
            "fax_number": "606-886-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN KY TENDER CARE PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANA",
        "authorized_official_first_name": "ANTOIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-886-7517",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000260816",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kennedy Eason
• East Kentucky Rehabilitation Center
• Eastern Kentucky Imaging, PSC
• Eastern Kentucky Physical Therapy, PSC
• Eastern Kentucky Tender Care Pediatrics LLC
• Amanda Eddington
• Nancy Edge
• Authur Edwards
• Brandon Edwards
• Jessica Edwards

• Rural Health Clinic/Center in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Rural Health Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.