FAMILY CARE CENTER SOUTH HARDIN (NPI# 1558311852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558311852 |
| Entity Type | Organization |
| Organization Name | FAMILY CARE CENTER SOUTH HARDIN |
| Practice Address |
11969 S Dixie Hwy Sonora KY 42776-9739 |
| Mailing Address |
Po Box 2309 Elizabethtown KY 42702-2309 |
| Practice Telephone | 2707061023 |
| Practice Fax Number | 2703699263 |
| Mailing Telephone | 2707061023 |
| Mailing Fax Number | 2707061167 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2010-03-11 |
| Authorized Official Name | MR. JEFF D KINGERY (DIRECTOR) |
| Authorized Official Telephone | 2707061046 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65934101 | 05 |
| Street Address |
11969 S DIXIE HWY |
| City | SONORA |
| State | KY |
| Zip Code | 42776-9739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699725044 | Bonnie Susanne Brown | Family Medicine | 11969 S Dixie Hwy, Sonora, KY 42776-9739 | 2006-05-10 |
| 1235460957 | Kelley Carrico-welch | Nurse Practitioner | 11969 S Dixie Hwy, Sonora, KY 42776-9739 | 2010-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538704184 | A Plus Family Healthcare LLC | Clinic/Center | 12080 South Dixie Highway, Sonora, KY 42776 | 2019-11-07 |
| 1508114463 | South Dixie Pharmacy LLC | Pharmacy | 12134 South Dixie Highway, Sonora, KY 42776 | 2012-08-27 |
| 1184907230 | Creekside Elementary School Satellite Clinic | Public Health or Welfare | 151 Horseshoe Bend Rd, Sonora, KY 42776-9329 | 2011-09-26 |
| 1972071215 | Cumberland Family Medical Center, Inc. | Nurse Practitioner | 151 Horseshoe Bend Rd, Sonora, KY 42776-9329 | 2018-11-05 |
| 1235336322 | Elizabeth A. Vinson | Physical Therapy Assistant | 2117 Nolin Rd, Sonora, KY 42776-9348 | 2007-07-02 |
| 1952649493 | Katelyn Tabb | Speech-Language Pathologist | 5253 Sonora Hardin Springs Rd, Sonora, KY 42776-9359 | 2013-01-17 |
| 1457801383 | Fruitful Speech, Pllc | Speech-Language Pathologist | 5253 Sonora Hardin Springs Rd, Sonora, KY 42776-9359 | 2016-10-04 |
| 1285160333 | Angela Waller | In Home Supportive Care | 311 Main St, Sonora, KY 42776-9707 | 2017-05-11 |
| 1114535911 | Lea Anne Bunch | Family Medicine | 12080 S Dixie Hwy, Sonora, KY 42776-9739 | 2020-07-17 |
| 1801169016 | Matthew Daniels | Pharmacist | 12134 S Dixie Hwy, Sonora, KY 42776-9739 | 2012-02-18 |
| Find all providers in zip 42776 | ||||
| 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 |
|---|---|---|---|---|
| 1114535911 | Lea Anne Bunch | Family Medicine | 12080 S Dixie Hwy, Sonora, KY 42776-9739 | 2020-07-17 |
| 1790132256 | Ryan Carey | Family Medicine | 900 Mono Way, Sonora, CA 95370-5229 | 2016-05-15 |
| 1306235957 | Michael Richard Portillo | Family Medicine | 680 Guzzi Ln Ste 106, Sonora, CA 95370-5288 | 2015-01-21 |
| 1952749608 | Donald Charles Waldman | Family Medicine | 22644 Sawmill Flat Rd, Sonora, CA 95370-8509 | 2013-06-04 |
| 1801043799 | Ralph Edward Retherford | Family Medicine | 20405 Lyons Bald Mtn Rd, Sonora, CA 95370-8780 | 2008-08-21 |
| 1124286885 | Tuolumne Me-wuk Indian Health Center, Inc. | Family Medicine | 19969 Greenley Rd, Suite B,c, & D, Sonora, CA 95370-5908 | 2008-05-29 |
| 1932318227 | Lori Beth Sostock | Family Medicine | 820 Delnero Dr, Suite B, Sonora, CA 95370-6208 | 2007-05-22 |
| 1952319816 | Ralph E Retherford Md Inc | Family Medicine | 16050 Via Este Rd, Sonora, CA 95370-8428 | 2006-08-04 |
| 1629097399 | Timothy D Hooper | Family Medicine | 13951 Mono Way, Ste A, Sonora, CA 95370-4856 | 2006-07-19 |
| 1851328298 | Steven A Smith | Family Medicine | 20044 Cedar Rd N, Mother Lode Medical Clinic, Sonora, CA 95370-5900 | 2006-06-28 |
| Find all providers in SONORA | ||||
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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.