BOURBON PHYSICIAN PRACTICE LLC (NPI# 1356689079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356689079 |
| Entity Type | Organization |
| Organization Name | BOURBON PHYSICIAN PRACTICE LLC |
| Other Organization Name | CARLISLE CLINIC |
| Practice Address |
107 S Broadway St Carlisle KY 40311-1150 |
| Practice Telephone | 8592894124 |
| Practice Fax Number | 8592894126 |
| Mailing Telephone | 8592894124 |
| Mailing Fax Number | 8592894126 |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2014-06-02 |
| Authorized Official Name | TIMOTHY VAUGHN (VICE PRESIDENT) |
| Authorized Official Telephone | 6155651513 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
KY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Carlisle Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790195717 | Bourbon Physician Practice LLC | Counselor | 9 Linville Dr, Paris, KY 40361-2129 | 2014-04-29 |
| Street Address |
107 S BROADWAY ST |
| City | CARLISLE |
| State | KY |
| Zip Code | 40311-1150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023068772 | Janet Tamaren | Family Medicine | 107 S Broadway St, Carlisle, KY 40311-1150 | 2006-05-12 |
| 1013300896 | Stacey M Anderson | Nurse Practitioner | 107 S Broadway St, Carlisle, KY 40311-1150 | 2015-03-18 |
| 1093070914 | Jennifer Bond | Nurse Practitioner | 107 S Broadway St, Carlisle, KY 40311-1150 | 2012-07-06 |
| 1164752903 | Kelly Butler-vise | Physician Assistant | 107 S Broadway St, Carlisle, KY 40311-1150 | 2009-12-29 |
| 1588690259 | Carlisle Clinic, Psc | Clinic/Center | 107 S Broadway St, Carlisle, KY 40311-1150 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205276292 | Ethel Ross | Developmental Therapist | 315 Rolling Acres Rd, Beaytyville, KY 40311 | 2013-07-05 |
| 1902140726 | Nicholas County Board of Education | Local Education Agency (LEA) | 395 W. Main St., Carlisle, KY 40311 | 2012-11-16 |
| 1487757761 | Mortenson Family Dental | Clinic/Center | 110 N. Locust St, Carlisle, KY 40311 | 2006-09-05 |
| 1699711010 | Ana Maria Rinaldini | Internal Medicine | 101 West Chestnut Street, Carlisle, KY 40311 | 2006-06-22 |
| 1205305661 | Sterling Health Solutions Inc | Clinic/Center | 133 School Dr, Carlisle, KY 40311 | 2018-11-15 |
| 1598910960 | Janey E Huff | Social Worker | 133 School Dr, Carlisle, KY 40311 | 2008-11-26 |
| 1366559734 | Anna Miller | Dentist | 110 N Locust St, Carlisle, KY 40311 | 2006-08-23 |
| 1710094867 | Wedco Distric Health Department | Public Health or Welfare | 133 School Dr, Carlisle, KY 40311-1052 | 2006-08-24 |
| 1245505908 | Carlisle Family Dental | Clinic/Center | 110 S Locust St, Carlisle, KY 40311-1123 | 2012-03-14 |
| 1093878613 | Gateway Pharmacy Group LLC | Durable Medical Equipment & Medical Supplies | 227 W Main St, Carlisle, KY 40311-1129 | 2006-12-18 |
| Find all providers in zip 40311 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699194704 | Mso Clinics, Inc. | Clinic/Center | 8685 Old Highway 41 South, Carlisle, IN 47838-8234 | 2014-04-16 |
| 1275827206 | Sullivan County Community Hospital | Clinic/Center | 8685 Old Highway 41 South, Carlisle, IN 47838-8234 | 2011-06-07 |
| 1093042038 | Jmhc Inc | Clinic/Center | 2330 Concrete Rd, Carlisle, KY 40311-9700 | 2009-11-12 |
| 1588690259 | Carlisle Clinic, Psc | Clinic/Center | 107 S Broadway St, Carlisle, KY 40311-1150 | 2006-06-24 |
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|---|---|---|---|---|
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| 1316553167 | Flaget Healthcare Inc | Clinic/Center | 2387 Main St, Willisburg, KY 40078-8102 | 2020-09-17 |
| 1710590880 | Flaget Healthcare, Inc | Clinic/Center | 4359 Shepherdsville Road, Ste 255, Bardstown, KY 40004 | 2020-08-28 |
| 1649881335 | Emerald Therapy Center, LLC | Clinic/Center | 111 Poplar St, Murray, KY 42071-2571 | 2020-08-14 |
| 1407472319 | Family Health Care Associates 7 Limited Liability Company | Clinic/Center | 422 N Highway 27, Whitley City, KY 42653 | 2020-06-17 |
| 1154950699 | Family Health Care Associates 6 Limited Liability Company | Clinic/Center | 8070 Us Highway 60 W, Lewisport, KY 42351-7087 | 2020-04-06 |
| 1568098838 | Appalachian Regional Healthcare, Inc | Clinic/Center | 186 Breanna Blvd, Suite 100, Salyersville, KY 41465-7525 | 2020-03-19 |
| 1780217794 | Family Health Care Associates 5 Limited Liability Company | Clinic/Center | 74 H&b Partin Lane, Pineville, KY 40977 | 2020-02-18 |
| 1023649514 | Memorial Hospital Inc | Clinic/Center | 485 Memorial Dr Ste 1, Manchester, KY 40962-9111 | 2020-02-03 |
| 1265072946 | Baptist Health Medical Group Inc | Clinic/Center | 800 Hospital Dr Fl 2, Madisonville, KY 42431-1658 | 2020-01-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.