| Mountain Family Practice Clinic Of Manchester Inc | |
|
86 Highway 638 Ste 1 Manchester KY 40962-7289 | |
| (606) 596-0701 | |
| (606) 596-0703 |
| Full Name | Mountain Family Practice Clinic Of Manchester Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 86 Highway 638, Manchester, Kentucky |
| Authorized Official Name and Position | Kim B Cox (OWNER/OPERATOR) |
| Authorized Official Contact | 8593584222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Family Practice Clinic Of Manchester Inc 86 Highway 638 Ste 1 Manchester KY 40962-7289 Ph: (606) 596-0701 | Mountain Family Practice Clinic Of Manchester Inc 86 Highway 638 Ste 1 Manchester KY 40962-7289 Ph: (606) 596-0701 |
| NPI Number | 1689919078 |
|---|---|
| Provider Enumeration Date | 12/11/2012 |
| Last Update Date | 08/29/2014 |
| Medicare PECOS PAC ID | 0143465617 |
|---|---|
| Medicare Enrollment ID | O20130404000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689919078 | NPI | - | NPPES |
| 7100299490 | Medicaid | KY | |
| 7100257320 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Pinkesh Patel |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1366591737 PECOS PAC ID: 2567358161 Enrollment ID: I20040223000186 |
| Provider Name | Karen Cheek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316052442 PECOS PAC ID: 0648245548 Enrollment ID: I20040901001169 |
| Provider Name | Hany Michael Oghia |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528067733 PECOS PAC ID: 1153360409 Enrollment ID: I20050427000322 |
| Provider Name | Bobbie M Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396958245 PECOS PAC ID: 7618962341 Enrollment ID: I20060222000720 |
| Provider Name | Kim Aprn Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326131434 PECOS PAC ID: 5496663601 Enrollment ID: I20070427000326 |
| Provider Name | Joel C Stephenson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356436372 PECOS PAC ID: 0446449441 Enrollment ID: I20110106000345 |
| Provider Name | Rebecca Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285072751 PECOS PAC ID: 8628219094 Enrollment ID: I20130726000624 |
| Provider Name | Cynthia P Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477985786 PECOS PAC ID: 3375770167 Enrollment ID: I20131227000707 |
| Provider Name | Susan Steitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376933614 PECOS PAC ID: 7517271034 Enrollment ID: I20150728005816 |
| Provider Name | Elena Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598139842 PECOS PAC ID: 6305140492 Enrollment ID: I20160210001617 |
| Provider Name | Alaina D Nevels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013460526 PECOS PAC ID: 8820383359 Enrollment ID: I20160823002880 |
| Provider Name | Tina Holbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902350556 PECOS PAC ID: 0042598245 Enrollment ID: I20161021001960 |
| Provider Name | Joanne Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932652096 PECOS PAC ID: 1254619216 Enrollment ID: I20161025002651 |
| Provider Name | Kristina M Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326498338 PECOS PAC ID: 0042598062 Enrollment ID: I20161026001650 |
| Provider Name | Carrie Ann Conn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255883906 PECOS PAC ID: 8224311972 Enrollment ID: I20170203001412 |
| Provider Name | Jordan Brittany Crutchfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366938441 PECOS PAC ID: 6709130180 Enrollment ID: I20181121002635 |
| Provider Name | Tina Shelton-coomer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821569393 PECOS PAC ID: 9931445780 Enrollment ID: I20190115002896 |
| Provider Name | Jessica Briggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558982140 PECOS PAC ID: 8527499102 Enrollment ID: I20200514002500 |
| Provider Name | Brittany A Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366076150 PECOS PAC ID: 8729400718 Enrollment ID: I20200619002230 |
| Provider Name | Clara E Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578032520 PECOS PAC ID: 3577981679 Enrollment ID: I20200921003003 |
| Provider Name | Tina Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114530904 PECOS PAC ID: 8921416124 Enrollment ID: I20210427002044 |
| Provider Name | Christina Callihan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164096483 PECOS PAC ID: 4789085325 Enrollment ID: I20210702000651 |
| Provider Name | Hazel Joy C Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295358927 PECOS PAC ID: 0648669697 Enrollment ID: I20211111002734 |
| Provider Name | Brittany L Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336891910 PECOS PAC ID: 5294129706 Enrollment ID: I20220228000428 |
| Provider Name | Gwendolyn Perch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710644810 PECOS PAC ID: 1355736182 Enrollment ID: I20220315000481 |
| Provider Name | Katilynn Treadway Newnam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336864404 PECOS PAC ID: 3072982800 Enrollment ID: I20221216001672 |
| Provider Name | Victoria P Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962128884 PECOS PAC ID: 2961873609 Enrollment ID: I20230117002556 |
| Provider Name | Tammy E Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669180717 PECOS PAC ID: 7719358332 Enrollment ID: I20230118002577 |
| Provider Name | Matthew Tighe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285315374 PECOS PAC ID: 1850735994 Enrollment ID: I20240216002875 |
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