NPI 1043650591 · live from the CMS NPI Registry
Clark Medical Ventures, LLC
Clinic/Center, Rural Health in Winchester, KY. National Provider Identifier 1043650591, active.
NPI record
| NPI | 1043650591 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Rural Health 261QR1300X |
| Practice location | 174 Pedro Way, Winchester, KY 40391 |
| Practice phone | 859-355-5653 |
| Mailing address | 1031 Wellington Way Ste 240, Lexington, KY 40513 |
| Enumerated | June 28, 2013 |
| Last updated | September 2, 2021 |
| Authorized official | Brittany Underwood, Credentialing Agent |
| Other names | Clark Family Care |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical | 103TC0700X | — (KY) |
| Social Worker, Clinical | 1041C0700X | — (KY) |
| Emergency Medicine | 207P00000X | — (KY) |
| Family Medicine | 207Q00000X | — (KY) |
| Internal Medicine | 207R00000X | — (KY) |
| Nurse Practitioner | 363L00000X | — (KY) |
| Nurse Practitioner, Acute Care | 363LA2100X | — (KY) |
| Nurse Practitioner, Family | 363LF0000X | — (KY) |
| Nurse Practitioner, Pediatrics | 363LP0200X | — (KY) |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — (KY) |
| Nurse Practitioner, Women's Health | 363LW0102X | — (KY) |
| Clinic/Center, Rural Health primary | 261QR1300X | 900176 (KY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.