Clover Fork Outpatient Medical Project Inc is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Evarts, Kentucky. The current practice location for Clover Fork Outpatient Medical Project Inc is 101 Chad St, Clover Fork Clinic, Evarts, Kentucky. For appointments, you can reach them via phone at
(606) 837-2108. The mailing address for Clover Fork Outpatient Medical Project Inc is 101 Chad St, Po Box39, Evarts, Kentucky and phone number is (606) 837-2108.
Clover Fork Outpatient Medical Project Inc is licensed to practice in Kentucky (license number ). The clinic also participates in the medicare program and its
NPI number is 1811939366. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(606) 837-2108.
Primary Care Clinic Profile
| Full Name | Clover Fork Outpatient Medical Project Inc |
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| Speciality | Clinic/Center |
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| Location | 101 Chad St, Evarts, Kentucky |
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| Authorized Official Name and Position | Britt Lewis (ADMINISTRATOR) |
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| Authorized Official Contact | 6068372108 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Clover Fork Outpatient Medical Project Inc
101 Chad St
Po Box39
Evarts
KY 40828-8200
Ph: (606) 837-2108 | Clover Fork Outpatient Medical Project Inc
101 Chad St
Clover Fork Clinic
Evarts
KY 40828-8200
Ph: (606) 837-2108 |
NPI Details:
| NPI Number | 1811939366 |
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| Provider Enumeration Date | 06/11/2006 |
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| Last Update Date | 11/19/2018 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 2062317027 |
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| Medicare Enrollment ID | O20040126000246 |
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Medical Identifiers
Medical identifiers for Clover Fork Outpatient Medical Project Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811939366 | NPI | - | NPPES |
| 31000045 | Medicaid | KY | |
| 7100323670 | Medicaid | KY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Kentucky) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 700006 (Kentucky) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Clover Fork Outpatient Medical Project Inc acts as a billing entity for following providers:
| Provider Name | Sharon Marie Colton |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1245264852
PECOS PAC ID: 6204739121
Enrollment ID: I20040129000031 |
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| Provider Name | Kristen M Nash |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1609308618
PECOS PAC ID: 0840561205
Enrollment ID: I20200914000531 |
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| Provider Name | Jessica Turner |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1639776990
PECOS PAC ID: 2062810534
Enrollment ID: I20211013003529 |
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