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CORBIN PEDIATRIC ASSOCIATES PSC NPI 1609960830


NPI Information

NPI: 1609960830
Provider Name: CORBIN PEDIATRIC ASSOCIATES PSC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
60 BRYAN BOULEVARD
STE 200
CORBIN, KY
ZIP 40701
Phone: (606) 528-9700
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CORBIN PEDIATRIC ASSOCIATES PSC is a rural health clinic center in Corbin, KY. CORBIN PEDIATRIC ASSOCIATES PSC NPI is 1609960830. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

60 BRYAN BOULEVARD
STE 200
CORBIN, KY
ZIP 40701
Phone: (606) 528-9700
Fax: (606) 528-8423

The provider's authorized official is Vernon Mitchell May .
The authorized official title is Managing Partner and has the following contact phone number (606) 528-9700.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 8/13/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatricsNo
2163W00000XRegistered NurseNo
3208000000XPediatricsNo
4261QR1300XClinic/CenterRural Health900173KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1183929MEDICARE OSCAR/CERTIFICATIONKENTUCKY
206918MEDICARE PINKENTUCKY
37100159920MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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