ERTEL MEDICINE & PEDIATRICS PSC NPI 1003842501

NPI Information

  • NPI: 1003842501
  • Provider Name: ERTEL MEDICINE & PEDIATRICS, PSC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • CLIA Number: 18D0975398
  • Address: 1520 BOONESBORO RD
    WINCHESTER, KY
    ZIP 40391
  • Phone: (859) 744-0067

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NPI Details

ERTEL MEDICINE & PEDIATRICS, PSC is a rural health clinic center in Winchester, KY. ERTEL MEDICINE & PEDIATRICS, PSC NPI is 1003842501. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1520 BOONESBORO RD
WINCHESTER, KY
ZIP 40391-816
Phone: (859) 744-0067
Fax: (859) 744-0042

The provider's authorized official is Larry Ertel .
The authorized official title is Owner and has the following contact phone number (859) 744-0067.

The CLIA number assigned to this NPI record is 18D0975398 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 8/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine35650KENTUCKYNo
2208000000XPediatricsNo
3261QR1300XClinic/CenterRural Health900132KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H24943MEDICARE UPINKENTUCKY
2183892MEDICARE OSCAR/CERTIFICATIONKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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