| Madison Family Clinic | |
|
2161 Lexington Rd Richmond KY 40475-7952 | |
| (859) 626-7794 | |
| (859) 626-7764 |
| Full Name | Madison Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2161 Lexington Rd, Richmond, Kentucky |
| Authorized Official Name and Position | Reba M. Bowling (OWNER CEO) |
| Authorized Official Contact | 8596267794 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Family Clinic 2161 Lexington Rd First Floor, Suite 5 Richmond KY 40475-7952 Ph: (859) 626-7794 | Madison Family Clinic 2161 Lexington Rd Richmond KY 40475-7952 Ph: (859) 626-7794 |
| NPI Number | 1891799177 |
|---|---|
| Provider Enumeration Date | 06/02/2005 |
| Last Update Date | 07/09/2020 |
| Medicare PECOS PAC ID | 5698749216 |
|---|---|
| Medicare Enrollment ID | O20040820000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891799177 | NPI | - | NPPES |
| 35001775 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 900185 (Kentucky) | Primary |
| Provider Name | Kimberly H Sowden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376686105 PECOS PAC ID: 5092815704 Enrollment ID: I20070711000067 |
| Provider Name | Kristin Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982144143 PECOS PAC ID: 8729352224 Enrollment ID: I20170921003706 |
| Provider Name | Isela Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841077716 PECOS PAC ID: 0143676676 Enrollment ID: I20231019002344 |
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