Kentucky Primary Medical Services LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

KENTUCKY PRIMARY MEDICAL SERVICES LLC

Practice address

311 Roy Campbell Dr
Hazard, KY 41701-9486

Phone

(606) 487-0776

Fax

(606) 487-0777

NPI assigned

Jul 2, 2012

Last updated

Feb 10, 2014By 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

Mr. Phillip Randy Mullins

Title

Ceo

Phone

(606) 487-0776

Specialties & licenses 2

Addresses

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.

• Delena H Young, A.R.N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, KY
  • NPI 1225290315
  NPD (past)

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1972867224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1797",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417021797",
            "telephone_number": "606-487-0776",
            "fax_number": "606-487-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 ROY CAMPBELL DR",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019486",
            "telephone_number": "606-487-0776",
            "fax_number": "606-487-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY PRIMARY MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "RANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-487-0776",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kentucky Mountain Imaging LLC
• Kentucky Mountain Radiology Services PLLC
• Kentucky Pain Management Services
• Kentucky Pain Physicians
• Kentucky Pain Physicians, PSC
• Kentucky River Area Dev Dist
• Kentucky River Children's Advocacy Center
• Kentucky River Community Care, Inc
• Kentucky River Community Care, Inc
• Kentucky River Community Care, Inc

• Primary Care Clinic/Center in Hazard, KY
• Providers in Hazard, 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 Feb 10, 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.