NPIMap

Organization Active NPI

Family Health Care Associates 3

  • Rural Health Clinic/Center
  • Somerset, KY
National Provider Identifier
1922582410
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FAMILY HEALTH CARE ASSOCIATES 3
Practice address
1056 S Highway 27 Ste 12
Somerset, KY 42501-2893
Phone
(606) 425-4424
NPI assigned
Sep 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Mrs. Gina Good, APRNNPI 1831167584
Title
Owner/Provider
Phone
(606) 546-7777

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
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1056 S Highway 27 Ste 12
Somerset, KY 42501-2893

Mailing address

PO Box 1535
Barbourville, KY 40906-5535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190701000535 KY Part A Provider - Rural Health Clinic 4183958879 Practice locations: Somerset, KY

Rural health clinic certification: CCN B03833

Legal name
FAMILY HEALTH CARE ASSOCIATES 3
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 3, 2021
Last certification
Mar 3, 2021
Ownership / control type
1A
Organization structure
LLCProprietary
Incorporated
Jul 9, 2018 in KY
Enrollment address
1056 S Highway 27
Ste 12
Somerset, KY 42501-2893

National Provider Directory

National Provider Directory

Locations

1056 S Highway 27
Ste 12
Somerset, KY 42501
Phone (606) 425-4424

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gina Good Individual 5% Or Greater Direct Ownership InterestOwner Jul 9, 2018 100%
W-2 Managing EmployeeOwner/Ceo Jul 9, 2018

Owners & managing parties with NPI records 1

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

  • Gina Good, APRN
    • Family Nurse Practitioner
    • Barbourville, KY
    • NPI 1831167584

    5% Or Greater Direct Ownership Interest, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 3

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": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1922582410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409065535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 S HIGHWAY 27 STE 12",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012893",
            "telephone_number": "606-425-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CARE ASSOCIATES 3",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "GOOD",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "606-546-7777",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.