STONECREST FAMILY MEDICINE PLLC NPI 1659322808

NPI Information

NPI: 1659322808
Provider Name: STONECREST FAMILY MEDICINE PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 18D1052501

Address:
101 STONECREST ROAD
SUITE 3
SHELBYVILLE, KY
ZIP 40065
Phone: (502) 633-5565
Get Directions

STONECREST FAMILY MEDICINE PLLC is a primary care clinic center in Shelbyville, KY. STONECREST FAMILY MEDICINE PLLC NPI is 1659322808. The provider is registered as an organization entity type.

The provider's business location address is:

101 STONECREST ROAD
SUITE 3
SHELBYVILLE, KY
ZIP 40065
Phone: (502) 633-5565
Fax: (502) 633-5154

The provider's authorized official is Ronald E Creque .
The authorized official title is Owner and has the following contact phone number (502) 633-5565.

The CLIA number assigned to this NPI record is 18D1052501 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 8/20/2014.

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
1	261QP2300X	Clinic/Center	Primary Care	36516	KENTUCKY	Yes

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
1	=========	OTHER	KENTUCKY	TAX INDENTIFICATION

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: 5/5/2024

NPI Synchronization or Removal

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.

« Previous NPI

Next NPI »