NPIMap

Organization Active NPI

Industrial Wellness Services of Kentucky, PLLC

  • Corporate Health Clinic/Center
  • Pine Knot, KY
National Provider Identifier
1851618607
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corporate Health Clinic/CenterTaxonomy code 261QC1800X
Legal business name
INDUSTRIAL WELLNESS SERVICES OF KENTUCKY, PLLC
Practice address
55 W Cal Hill Spur
Pine Knot, KY 42635-9194
Phone
(606) 376-9355
Fax
(606) 376-9356
NPI assigned
May 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Mr. Dustin Hamlin, APRNNPI 1912324609
Title
President
Phone
(606) 376-9355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Corporate Health Clinic/Center 261QC1800X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

55 W Cal Hill Spur
Pine Knot, KY 42635-9194

Mailing address

PO Box 41
Whitley City, KY 42653-0041
Phone (606) 376-9355

Other names 1

  • Appalachian Family Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140903001931 KY Part B Supplier - Clinic/Group Practice 3577781582 Receives reassigned benefits from 6 practitioners
Practice locations: Pine Knot, KY
O20191106000601 KY Part A Provider - Rural Health Clinic 3577781582 Practice locations: Pine Knot, KY

Rural health clinic certification: CCN B03801

Legal name
INDUSTRIAL WELLNESS SERVICES OF KENTUCKY PLLC
Doing business as
APPALACHIAN FAMILY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 11, 2019
Last certification
Dec 11, 2019
Ownership / control type
1A
Organization structure
LLCProprietary
Incorporated
Oct 1, 2010 in KY
Enrollment address
55 W Cal Hill Spur
Pine Knot, KY 42635-9194

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
18D2085922Appalachian Family Care55W Cal Hill Spur, Pine Knot, KY 42635Certificate of waiverOct 26, 2026

National Provider Directory

National Provider Directory

Locations

1570 N Highway 27
Whitley City, KY 42653
Phone (606) 376-9355

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
Dustin C Hamlin Individual 5% Or Greater Direct Ownership Interest Oct 1, 2010 100%
Corporate OfficerPresident Oct 1, 2010
Corporate DirectorPresident Oct 1, 2010
Amber Birney Individual W-2 Managing EmployeeOffice Manager Nov 1, 2019
Operational/Managerial ControlOfficer Manager Mar 15, 2015

Owners & managing parties with NPI records 1

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

  • Dustin Hamlin, APRN
    • Family Nurse Practitioner
    • Whitley City, KY
    • NPI 1912324609

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1851618607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41",
            "city": "WHITLEY CITY",
            "state": "KY",
            "postal_code": "426530041",
            "telephone_number": "606-376-9355",
            "fax_number": "606-376-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W CAL HILL SPUR",
            "city": "PINE KNOT",
            "state": "KY",
            "postal_code": "426359194",
            "telephone_number": "606-376-9355",
            "fax_number": "606-376-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDUSTRIAL WELLNESS SERVICES OF KENTUCKY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-03",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "HAMLIN",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-376-9355",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Appalachian Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pine Knot, KY

Sources for this page

Verify at the official NPI Registry.