| Rural Family Practice | |
|
133 Plaza Dr Suite 3 Berea KY 40403-2087 | |
| (859) 986-1370 | |
| (859) 986-1374 |
| Full Name | Rural Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 133 Plaza Dr, Berea, Kentucky |
| Authorized Official Name and Position | Nawar Soda (OWNER) |
| Authorized Official Contact | 8599861370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rural Family Practice 133 Plaza Dr Suite 3 Berea KY 40403-2087 Ph: (859) 986-1370 | Rural Family Practice 133 Plaza Dr Suite 3 Berea KY 40403-2087 Ph: (859) 986-1370 |
| NPI Number | 1649401563 |
|---|---|
| Provider Enumeration Date | 07/28/2009 |
| Last Update Date | 08/13/2026 |
| Certification Date | 08/13/2026 |
| Medicare PECOS PAC ID | 9830238823 |
|---|---|
| Medicare Enrollment ID | O20091204000183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649401563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (NU) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (NU) | Secondary |
| 207Q00000X | Family Medicine | (NU) | Secondary |
| Provider Name | Mark O Catron |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811933989 PECOS PAC ID: 1658274758 Enrollment ID: I20040128000109 |
| Provider Name | Thomas W Fowles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285679100 PECOS PAC ID: 7810928058 Enrollment ID: I20050826000495 |
| Provider Name | Nawar Soda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083812598 PECOS PAC ID: 5698715092 Enrollment ID: I20080122000005 |
| Provider Name | Kristin Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982144143 PECOS PAC ID: 8729352224 Enrollment ID: I20170921003706 |
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