TRI STATE FAMILY MEDICAL CENTER, LLC (NPI# 1194959452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194959452 |
| Entity Type | Organization |
| Organization Name | TRI STATE FAMILY MEDICAL CENTER, LLC |
| Practice Address |
2583 Highway 644 Ste 1 Louisa KY 41230-9436 |
| Practice Telephone | 6066383131 |
| Practice Fax Number | 6066383139 |
| Mailing Telephone | 6066383131 |
| Mailing Fax Number | 6066383139 |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2014-12-09 |
| Authorized Official Name | MRS. JANICE GAUZE (VICE PRESIDENT) |
| Authorized Official Telephone | 6066383131 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
3007167 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
25469 | Ambulatory Health Care Facilities | |
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
25469 | KY | Ambulatory Health Care Facilities |
| Y | 207Q00000X | Family Medicine | 25469 | KY | Allopathic & Osteopathic Physicians |
| Street Address |
2583 HIGHWAY 644 STE 1 |
| City | LOUISA |
| State | KY |
| Zip Code | 41230-9436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811533599 | Addiction Recovery Care LLC | Substance Abuse Rehabilitation Facility | 105-107 E Madison St., Louisa, KY 41230 | 2019-11-18 |
| 1780236570 | Addiction Recovery Care LLC | Substance Abuse Rehabilitation Facility | 1640 Jerushia Branch Rd., Booneville, KY 41230 | 2019-07-11 |
| 1922528272 | Samantha Paige Stanley | Peer Specialist | 221 Windy Hill Drive, Louisa, KY 41230 | 2017-06-27 |
| 1407393457 | Chandra D Blevins | Peer Specialist | 125 N. Main Cross St., Louisa Office Addiction Recovery Care, Louisa, KY 41230 | 2017-01-30 |
| 1033654876 | Amanda Hurley | Peer Specialist | 125 N. Main Cross Street, Louisa, KY 41230 | 2017-01-04 |
| 1780127753 | Dakota Williams | Peer Specialist | 125 N Cross Main St, Louisa, KY 41230 | 2016-11-23 |
| 1568905529 | Tara Runyon | Peer Specialist | 125 N Main Cross Street, Louisa, KY 41230 | 2016-11-23 |
| 1134575624 | Misty Howell I | Peer Specialist | 125 S. Main Cross Street, Louisa, KY 41230 | 2016-05-13 |
| 1720404478 | Louisa Dental Care | Dentist | 203 S. Water St, Louisa, KY 41230 | 2014-03-05 |
| 1326336728 | Elite Chiropractic Psc | Chiropractor | 4347 Highway 2565, Louisa, KY 41230 | 2011-07-19 |
| Find all providers in zip 41230 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316476336 | Ohio Valley Physicians Inc | Family Medicine | 108 W Madison St Ste A, Louisa, KY 41230-1327 | 2017-06-05 |
| 1083943575 | Odyssey Inc | Family Medicine | 104 North Rice Street, Louisa, KY 41230 | 2009-12-14 |
| 1437348513 | Josie Kinkade | Family Medicine | 6045 Yanceyville Rd, Louisa, VA 23093-4237 | 2007-10-15 |
| 1922178052 | Jeremy C Klein | Family Medicine | 40 Medical Hts, Louisa, KY 41230-9603 | 2006-11-08 |
| 1598859464 | Marc Alan Workman | Family Medicine | 412 N Lock Ave, Louisa, KY 41230 | 2006-10-03 |
| 1558374249 | Edward Rex Harkrader Sr. | Family Medicine | 101 Woolfolk Ave, Louisa, VA 23093 | 2006-08-14 |
| 1710907985 | Alex H. Rizk | Family Medicine | 575 Industrial Drive, Uva Medical Associates of Louisa, Louisa, VA 23093 | 2006-07-20 |
| 1427089028 | Alger Rixey Southall IIi | Family Medicine | 101 Woolfolk Ave., Louisa, VA 23093 | 2006-07-05 |
| 1689646879 | Michael D Richmond | Family Medicine | 115 Jefferson Hwy Ste 9, Louisa, VA 23093-6563 | 2006-02-02 |
| 1134491376 | Chad Mccreary | Family Medicine | 412 N Lock Ave, Louisa, KY 41230-1115 | 2012-02-03 |
| Find all providers in LOUISA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.