Family Care Professional Limited Liability Company

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

FAMILY CARE PROFESSIONAL LIMITED LIABILITY COMPANY

Doing business as

Family Clinic

Practice address

3190 Irvine Rd.
Richmond, KY 40475-4047

Phone

(859) 369-0070

Fax

(859) 369-0073

NPI assigned

Oct 30, 2017

Organization subpart

No

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

Authorized official

Name

Jeryl Lynn Pittman, APRNNPI 1891990479

Title

Member/Owner

Phone

(859) 893-3588

Specialties & licenses 1

Addresses

Other names 1

• FAMILY CLINIC Doing business as

Locations

Practitioners 1

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.

• Jeryl Lynn Pittman, APRN

  • Primary Care Nurse Practitioner
  • Richmond, KY
  • NPI 1891990479
  Authorized official Same address or phone

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509321600000",
    "number": "1932611019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4864 BUD LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405141416",
            "telephone_number": "859-358-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 IRVINE RD.",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404754047",
            "telephone_number": "859-369-0070",
            "fax_number": "859-369-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE PROFESSIONAL LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "JERYL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "859-893-3588",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Richmond, KY
• Providers in Richmond, 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 Oct 30, 2017; 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.