NPIMap

Organization Active NPI

Faith Healthcare, Inc.

Doing business as Stanford Community Care

  • Family Medicine Physician
  • Stanford, KY
National Provider Identifier
1902672918
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAITH HEALTHCARE, INC.
Doing business as
Stanford Community Care
Practice address
100 Jay St
Stanford, KY 40484-7511
Phone
(606) 365-1547
Fax
(606) 365-8380
NPI assigned
Nov 30, 2023
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
FAITH HEALTHCARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Logan Roy Antle
Title
Ceo
Phone
(606) 425-5768

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

100 Jay St
Stanford, KY 40484-7511

Mailing address

521 Crane Rd
Somerset, KY 42501-9503
Phone (066) 425-5768

Other names 1

  • Stanford Community Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Faith Healthcare Inc16 organizations share this tax ID, including this one
Part of
Faith Healthcare Inc

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1902672918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 CRANE RD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425019503",
            "telephone_number": "066-425-5768",
            "fax_number": "606-425-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JAY ST",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404847511",
            "telephone_number": "606-365-1547",
            "fax_number": "606-365-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAITH HEALTHCARE INC",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "ANTLE",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-425-5768"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanford Community Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stanford, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.