NPIMap

Organization Active NPI

Etown Family Practice PLC

  • Family Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1922443480
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007643 Issued in KY
Legal business name
ETOWN FAMILY PRACTICE PLC
Doing business as
Etown Family Practice
Practice address
1239 Woodland Dr
Suite 105
Elizabethtown, KY 42701-2770
Phone
(270) 900-0192
NPI assigned
May 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Authorized official

Name
Gwen Thomas, APRN
Title
Aprn
Phone
(270) 900-0192

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X KY3007643 KY
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 3007643 KY Primary

Addresses

Primary practice location

1239 Woodland Dr
Suite 105
Elizabethtown, KY 42701-2770

Mailing address

1239 Woodland Dr
Ste 105
Elizabethtown, KY 42701-2770
Phone (270) 900-0192

Other names 1

  • Etown Family Practice Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1922443480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 WOODLAND DR",
            "address_2": "STE 105",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012770",
            "telephone_number": "270-900-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 WOODLAND DR",
            "address_2": "SUITE 105",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012770",
            "telephone_number": "270-900-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETOWN FAMILY PRACTICE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "GWEN",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "270-900-0192",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "KY3007643",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Etown Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.