NPIMap

Organization Active NPI

Fibro Care Clinic, LLC

Doing business as Birk Grove Life Centre

  • Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1942466784
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4806P Issued in KY
Legal business name
FIBRO CARE CLINIC, LLC
Doing business as
Birk Grove Life Centre
Practice address
5150 Village Square Dr
Paducah, KY 42001-9060
Phone
(270) 415-9575
NPI assigned
Jul 31, 2008
Last updated
Nov 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2008

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

Authorized official

Name
Kimberly Rommelman
Title
Business Manager
Phone
(270) 415-9575

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4806P KY Primary
Clinical Social Worker 1041C0700X 1672 KY
Physical Therapist 225100000X 003235 KY

Addresses

Primary practice location

5150 Village Square Dr
Paducah, KY 42001-9060

Mailing address

PO Box 7208
Paducah, KY 42002-7208
Phone (270) 415-9575

Other names 1

  • Birk Grove Life Centre Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1942466784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7208",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420027208",
            "telephone_number": "270-415-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 VILLAGE SQUARE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019060",
            "telephone_number": "270-415-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIBRO CARE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-31",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "ROMMELMAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "270-415-9575"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4806P",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1672",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "003235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Birk Grove Life Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; 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.