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PRIMECARE PSC NPI 1023091600


NPI Information

NPI: 1023091600
Provider Name: PRIMECARE PSC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 18D0326895

Address:
2413 RING RD STE 110
ELIZABETHTOWN, KY
ZIP 42701
Phone: (270) 765-4535
Get Directions

PRIMECARE PSC is a family medicine in Elizabethtown, KY. The provider is 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. PRIMECARE PSC NPI is 1023091600. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2413 RING RD STE 110
ELIZABETHTOWN, KY
ZIP 42701-924
Phone: (270) 765-4535
Fax: (270) 763-1901

The provider's authorized official is David J. Zoeller .
The authorized official title is Physician/owner and has the following contact phone number (270) 765-4535.

The CLIA number assigned to this NPI record is 18D0326895 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/28/2005 and was last updated on 11/17/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QA0401XFamily MedicineAddiction MedicineNo
2363AM0700XPhysician AssistantMedicalNo
3363L00000XNurse PractitionerNo
4207Q00000XFamily Medicine26429KENTUCKYYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11507510MEDICAIDTENNESSEE
278904083MEDICAIDKENTUCKY
365922940MEDICAIDKENTUCKY
47100060440MEDICAIDKENTUCKY

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.