Lewis County Primary Care Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

LEWIS COUNTY PRIMARY CARE CENTER, INC.

Doing business as

PrimaryPlus

Practice address

502 S 2ND St
Ripley, OH 45167-1306

Phone

(937) 744-4343

Fax

(937) 744-4344

NPI assigned

Mar 10, 2020

Last updated

Mar 10, 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

Jerry Ugrin

Title

Ceo

Phone

(606) 796-3029

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PrimaryPlus Doing business as

Locations

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1992330997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411790550",
            "telephone_number": "606-796-3029",
            "fax_number": "606-202-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 S 2ND ST",
            "city": "RIPLEY",
            "state": "OH",
            "postal_code": "451671306",
            "telephone_number": "937-744-4343",
            "fax_number": "937-744-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS COUNTY PRIMARY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "UGRIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-796-3029"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31000268",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0864613",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrimaryPlus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Ruth Howelett
• Esther Naomi Kemmeter
• (Dodie) Doris J. Kirby, LPN
• Carissa Kirk, NP-C
• Sandra Marie Kistler
• Kaitlin Maloff, M.A./C.A.S
• Danette Dawn Martin
• Madeline Miller, DPT
• Jennifer Lynn Moffett, RN
• Monica L Mussinan

• Federally Qualified Health Center (FQHC) in Ripley, OH
• Providers in Ripley, OH by specialty
• Federally Qualified Health Center (FQHC) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.