Licking Valley Internal Medicine & Pediatrics Psc
Internal Medicine in Cynthiana, KY. Organization (NPI-2).
NPI number1225136153
StatusActive
Last updated in NPPESApr 7, 2010
Details
- NPI
- 1225136153
- Entity type
- Organization (NPI-2)
- Legal business name
- Licking Valley Internal Medicine & Pediatrics Psc
- Organization subpart
- No
- Enumeration date
- Sep 21, 2006
- Last updated
- Apr 7, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 208000000X | Pediatrics | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – | |
| 363A00000X | Physician Assistant | – | – |
Practice location
1210 Ky Highway 36 ESuite 2a
Cynthiana, KY 41031-7490
Phone 859-234-9611 · Fax 859-235-0878
Mailing address
1210 Ky Highway 36 ESuite 2a
Cynthiana, KY 41031-7490
Phone 859-234-9611 · Fax 859-235-0878
Authorized official
William Frank McKemie
President
8592349611
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