Provider Demographics
NPI:1639536600
Name:1ON1 MEDICAL CARE
Entity Type:Organization
Organization Name:1ON1 MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHEMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-962-7305
Mailing Address - Street 1:3800 LAFAYETTE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-5332
Mailing Address - Country:US
Mailing Address - Phone:270-962-7305
Mailing Address - Fax:270-962-7306
Practice Address - Street 1:3800 LAFAYETTE RD
Practice Address - Street 2:SUITE A
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-5332
Practice Address - Country:US
Practice Address - Phone:270-962-7305
Practice Address - Fax:270-962-7306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY44328261QP2300X
KY1055261QP2300X, 261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine