Provider Demographics
NPI:1215069885
Name:FAMILY CARE ASSOCIATES, PSC
Entity type:Organization
Organization Name:FAMILY CARE ASSOCIATES, PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-234-6000
Mailing Address - Street 1:1120 W SHELBY ST
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:KY
Mailing Address - Zip Code:41040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1120 W SHELBY ST
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:KY
Practice Address - Zip Code:41040
Practice Address - Country:US
Practice Address - Phone:859-654-6966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY CARE ASSOCIATES, PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-09
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65928608Medicaid
KY65928608Medicaid