Organization Active NPI

Primary Care Partner and Telehealth LLC

  • Clinic/Center
  • Lucasville, OH
National Provider Identifier
1871457135
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PRIMARY CARE PARTNER AND TELEHEALTH LLC
Practice address
6402 Millers Run Back Run Rd
Lucasville, OH 45648-8726
Phone
(740) 370-8884
Fax
(740) 212-8511
NPI assigned
Dec 11, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Amanda Bentley, NPNPI 1912747668
Title
FNP-BC
Phone
(740) 370-8884

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

6402 Millers Run Back Run Rd
Lucasville, OH 45648-8726

Mailing address

6402 Millers Run Back Run Rd
Lucasville, OH 45648-8726
Phone (740) 370-8884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260226003343 OH Part B Supplier - Clinic/Group Practice 7214418243 Receives reassigned benefits from 1 practitioner
Practice locations: Lucasville, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1765411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1871457135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6402 MILLERS RUN BACK RUN RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456488726",
            "telephone_number": "740-370-8884",
            "fax_number": "740-212-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6402 MILLERS RUN BACK RUN RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456488726",
            "telephone_number": "740-370-8884",
            "fax_number": "740-212-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PARTNER AND TELEHEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-11",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "FNP-BC",
        "authorized_official_telephone_number": "740-370-8884",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucasville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.