NPIMap

Organization Active NPI

Parkway Medical Clinic

  • Family Medicine Physician
  • Manchester, KY
National Provider Identifier
1992965032
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PARKWAY MEDICAL CLINIC
Practice address
454 Manchester Square SHPG Ctr
Manchester, KY 40962-8781
Phone
(606) 598-5115
Fax
(606) 598-7179
NPI assigned
Jun 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Authorized official

Name
Ms. Judy Reynolds
Title
Office Manager
Phone
(606) 598-5115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

454 Manchester Square SHPG Ctr
Manchester, KY 40962-8781

Mailing address

PO Box 369
Manchester, KY 40962-0369
Phone (606) 598-5115

Other identifiers 1

IdentifierTypeStateIssuer
65920480MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1213228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1992965032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409620369",
            "telephone_number": "606-598-5115",
            "fax_number": "606-598-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 MANCHESTER SQUARE SHPG CTR",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409628781",
            "telephone_number": "606-598-5115",
            "fax_number": "606-598-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-598-5115",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65920480",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.