FAMILY WELLCARE CLINIC, PLLC (NPI# 1619496395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619496395 |
| Entity Type | Organization |
| Organization Name | FAMILY WELLCARE CLINIC, PLLC |
| Practice Address |
805 Bardstown Rd Ste 12 Springfield KY 40069 |
| Mailing Address |
805 Bardstown Rd Ste 12 Springfield KY 40069-1515 |
| Practice Telephone | (859) 481-7113 |
| Practice Fax Number | 8594817114 |
| Mailing Telephone | 8594817113 |
| Mailing Fax Number | 8594817114 |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2018-07-23 |
| Authorized Official Name | IMAD ANTONE HADDAD (MANAGER) |
| Authorized Official Telephone | 8594817113 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64065865 | 05 |
| Street Address |
805 BARDSTOWN RD STE 12 |
| City | SPRINGFIELD |
| State | KY |
| Zip Code | 40069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508880063 | Imad Haddad | Internal Medicine | 805 Bardstown Rd Ste 12, Springfield, KY 40069-1515 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972901189 | Fred's Stores of Tennessee Inc | Pharmacy | 1117 Lincoln Park Rd, Springfield, KY 40069 | 2014-12-22 |
| 1730455346 | Christina Nicole Saunier | Speech-Language Pathologist | 716 East Grundy Ave, Springfield, KY 40069 | 2012-03-28 |
| 1912157207 | Allison Brooke Ballard | Social Worker | 2373 Lincoln Park Rd, Springfield, KY 40069 | 2008-09-24 |
| 1497737001 | Lincoln Trail District Health Dept | Public Health or Welfare | 302 E Main St, Springfield, KY 40069 | 2005-11-18 |
| 1497267637 | Jonathon Lee Ennis | Physician Assistant | 805 Bardstown Rd, Springfield, KY 40069 | 2017-10-27 |
| 1750562690 | Washington County Schools | Local Education Agency (LEA) | 120 Mackville Hl, Springfield, KY 40069-1013 | 2007-11-20 |
| 1912028309 | Colette M Hill | Massage Therapist | 114 S Walnut St, Springfield, KY 40069-1104 | 2007-04-03 |
| 1083751424 | Communicare Inc | Community/Behavioral Health | 324 E Main St, Springfield, KY 40069-1127 | 2007-02-01 |
| 1639654809 | Bardstown Primary Care, Pllc | Clinic/Center | 102 W Depot St, Springfield, KY 40069-1159 | 2018-10-03 |
| 1376617837 | Extendicare Homes, Inc. | Skilled Nursing Facility | 420 E Grundy Ave, Springfield, KY 40069-1173 | 2006-11-17 |
| Find all providers in zip 40069 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639654809 | Bardstown Primary Care, Pllc | Clinic/Center | 102 W Depot St, Springfield, KY 40069-1159 | 2018-10-03 |
| 1326496100 | Sgoh Acquisition, Inc. | Clinic/Center | 2828 N National Ave, Springfield, MO 65803-4306 | 2016-06-02 |
| 1508141961 | Spring View Hospital LLC | Clinic/Center | 79 Bobolink Dr, Springfield, KY 40069-1516 | 2011-10-18 |
| 1669565677 | Southeast Colorado Hospital District | Clinic/Center | 900 Church St, Springfield, CO 81073-1636 | 2006-10-02 |
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|---|---|---|---|---|
| 1669072757 | Arh Mary Breckinridge Health Services, Inc. | Clinic/Center | 302 Walnut Street, Pineville, KY 40977 | 2020-10-28 |
| 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 | ||||
| City | SPRINGFIELD |
| Zip Code | 40069 |
Please comment or provide details below to improve the information on FAMILY WELLCARE CLINIC, PLLC.
| 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.