Rineyville Family Medical Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

RINEYVILLE FAMILY MEDICAL CLINIC LLC

Practice address

423 Crume Rd
Vine Grove, KY 40175-1130

Phone

(270) 900-1236

NPI assigned

Nov 9, 2018

Last updated

Apr 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessi Lloyd, APRNNPI 1295257517

Title

Owner

Phone

(270) 900-1236

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessi Diana Lloyd, NP-C

  • Family Nurse Practitioner
  • Vine Grove, KY
  • NPI 1295257517
  Medicare reassignment Authorized official
• Michelle Leigh Higdon, PT, DPT

  • Physical Therapist
  • Rineyville, KY
  • NPI 1033247259
  NPD

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1922576768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 JAKE DR",
            "city": "RINEYVILLE",
            "state": "KY",
            "postal_code": "401629462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 CRUME RD",
            "city": "VINE GROVE",
            "state": "KY",
            "postal_code": "401751130",
            "telephone_number": "270-900-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RINEYVILLE FAMILY MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-09",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "LLOYD",
        "authorized_official_first_name": "JESSI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-900-1236",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100476030",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Possibility Place PSC
• Julie Mruz Powers, MSSW
• Gregory S Puckett, DMD
• Makenzie Putzier, LCSW
• Brianna Lynette Redeaux
• Amanda Lisa Sandoval
• Paul Robert Seitz Jr., D.C.
• Alicia Sharp
• Holly Samantha Sheroan, M.S. CCC-SLP
• Shiloh City of Peace Foundation

• Primary Care Clinic/Center in Vine Grove, KY
• Providers in Vine Grove, KY by specialty
• Primary Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.