BEREA URGENT CARE LLC NPI 1912054792

NPI Information

NPI: 1912054792
Provider Name: BEREA URGENT CARE LLC
Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization
CLIA Number: 18D1046850
Address: 234 BRENWOOD ST
BEREA, KY
ZIP 40403
Phone: (859) 985-0302

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NPI Details

BEREA URGENT CARE LLC is a nurse practitioner in Berea, KY. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. BEREA URGENT CARE LLC NPI is 1912054792. The provider is registered as an organization entity type.

The provider's business location address is:

234 BRENWOOD ST
BEREA, KY
ZIP 40403-637
Phone: (859) 985-0302
Fax: (859) 985-0308

The provider's authorized official is Nawar Soda .
The authorized official title is Partner and has the following contact phone number (859) 985-0302.

The CLIA number assigned to this NPI record is 18D1046850 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc (HCPCS:U0002)

The enumeration date for this NPI number is 1/4/2007 and was last updated on 5/12/2016.

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	Primary
1	261QU0200X	Clinic/Center	Urgent Care	No
2	363A00000X	Physician Assistant		No
3	363L00000X	Nurse Practitioner		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	65944373	MEDICAID	KENTUCKY
2	18D1046850	OTHER	KENTUCKY	CLIA

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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