NPIMap

Organization Active NPI

Lon Lafferty MD PSC

  • Rural Health Clinic/Center
  • Inez, KY
National Provider Identifier
1992992572
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LON LAFFERTY MD PSC
Practice address
RT 40 East Blacklog Rd
Inez, KY 41224
Phone
(606) 298-7405
Fax
(606) 298-3284
NPI assigned
Sep 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
Lon E Lafferty, MDNPI 1194724229
Title
Owner
Phone
(606) 298-7405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QA0505X 24313 KY
Rural Health Clinic/Center 261QR1300X Primary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X 4341P KY

Addresses

Primary practice location

RT 40 East Blacklog Rd
Inez, KY 41224

Mailing address

PO Box 1304
Inez, KY 41224-1304
Phone (606) 298-4705

Other names 1

  • Lafferty Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080529000685 KY Part B Supplier - Clinic/Group Practice 4880764141 Receives reassigned benefits from 3 practitioners
Practice locations: Inez, KY
O20080730000727 KY Part A Provider - Rural Health Clinic 4880764141 Practice locations: Inez, KY

Rural health clinic certification: CCN 183959

Legal name
LON LAFFERTY MD PSC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 28, 2008
Last certification
Oct 6, 2015
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jun 5, 2001 in KY
Enrollment address
2160 Blacklog Rd
Ste 120
Inez, KY 41224-9019

National Provider Directory

National Provider Directory

Locations

2160 Blacklog Rd
Inez, KY 41224
Phone (606) 295-5028

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lon E Lafferty Individual 5% Or Greater Direct Ownership InterestOwner, Managerial Jun 5, 2001
Operational/Managerial ControlOwner Jun 5, 2001 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Lon E Lafferty, MD
    • Adult Medicine Physician
    • Inez, KY
    • NPI 1194724229

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 5

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": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1992992572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1304",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412241304",
            "telephone_number": "606-298-4705",
            "fax_number": "606-298-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RT 40 EAST BLACKLOG RD",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "41224",
            "telephone_number": "606-298-7405",
            "fax_number": "606-298-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LON LAFFERTY MD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "LAFFERTY",
        "authorized_official_first_name": "LON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-298-7405",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "KY",
            "license": "24313",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4341P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lafferty Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inez, KY

Sources for this page

Verify at the official NPI Registry.