1. Home
  2. Directory
  3. Kentucky
  4. Russellville
  5. Clinic Center
  6. NPI Profile

SOUTHERN KENTUCKY PRIMARY CARE, P.S.C.
NPI 1003327412
Clinic/Center - Rural Health in Russellville, KY

Active since October 12, 2017CLIA 18D2144252 · Waiver
101 W 2ND ST, RUSSELLVILLE, KY 42276(270) 881-1813(270) 886-6600 Get Directions Write a Review

NPPES record last updated: June 15, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 15, 2018, Mar 7, 2018, Oct 12, 2017 (3 updates tracked since 2017).

About Southern Kentucky Primary Care, P.s.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN KENTUCKY PRIMARY CARE, P.S.C. (NPI 1003327412) is a healthcare organization registered as a rural health in Russellville, Kentucky and active in the NPI registry since October 2017. The organization holds a CLIA Waiver certificate valid through February 12, 2028 and lists Latisha Edmonds, Office Administrator, as its authorized official.

NPPES Registry Identity

NPI1003327412
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSOUTHERN KENTUCKY PRIMARY CARE, P.S.C.
Location Address101 W 2ND STRussellville, KY 42276
Mailing Address1739 Canton StHopkinsville, KY 42240-1991 · (270) 881-1813 · Fax (270) 886-6008
Phone(270) 881-1813
Fax(270) 886-6600
Organization SubpartNo
Authorized OfficialLatisha EdmondsOffice Administrator · (270) 265-2574
Enumeration DateOctober 12, 2017
Last NPPES UpdateJune 15, 20183 updates tracked since enumeration
✔ NPI 1003327412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
101 W 2ND ST, Russellville, KY 42276
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D2144252

Southern Kentucky Primary Care, Psc · Russellville, KY
Active · expires Feb 12, 2028
CLIA Number18D2144252
Laboratory TypeRural Health Clinic
Certificate Effective DateFebruary 13, 2026
Certificate Expiration DateFebruary 12, 2028
Laboratory DirectorGeeta S. Chavda
Laboratory Phone(270) 726-2602
Laboratory LocationSouthern Kentucky Primary Care, Psc101 W 2nd Street, Russellville, KY 42276
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LA'COYA DAYANI GARRARD FNP
Nurse Practitioner (Family)
101 W 2ND ST
RUSSELLVILLE, KY 42276
Logan County (270) 726-2602
AMANDA L FRANK MSN, RN, FNP-BC
Nurse Practitioner (Family)
101 W 2ND ST
RUSSELLVILLE, KY 42276
Logan County (270) 726-2602

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Kentucky Primary Care, P.S.C.'s NPI number?

The NPI number for Southern Kentucky Primary Care, P.S.C. is 1003327412. It was assigned to this organization in the NPPES registry on October 12, 2017.

Where is Southern Kentucky Primary Care, P.S.C. located?

Southern Kentucky Primary Care, P.S.C. is located at 101 W 2nd St, Russellville, KY 42276. The listed phone number is (270) 881-1813.

What is Southern Kentucky Primary Care, P.S.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Southern Kentucky Primary Care, P.S.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2144252) is associated with this NPI, valid through February 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Kentucky Primary Care, P.S.C. was last updated on June 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.