SOUTHERN KENTUCKY PRIMARY CARE, P.S.C.
NPI 1003327412
Clinic/Center - Rural Health in Russellville, KY
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
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Kentucky Primary Care, P.s.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Southern Kentucky Primary Care, P.S.C., which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (10)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, KYFrequently 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.
Is Southern Kentucky Primary Care, P.S.C. enrolled in Medicare?
Yes. Southern Kentucky Primary Care, P.S.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Kentucky Primary Care, P.S.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 3 Medicare specialties reassign their Medicare billing to Southern Kentucky Primary Care, P.S.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (8), Internal Medicine (1) and Pulmonary Disease (1). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
What insurance does Southern Kentucky Primary Care, P.S.C. accept?
Health plans from Anthem Blue Cross and Blue Shield list Southern Kentucky Primary Care, P.S.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
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.
# Southern Kentucky Primary Care, P.s.c. · NPI 1003327412
Rural Health organization in Russellville, Kentucky. Organization record, active in the CMS NPPES registry since October 12, 2017.
## Identity
- **NPI:** 1003327412 (Entity type: Organization)
- **Enumerated:** October 12, 2017
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Organization subpart:** No
- **Authorized official:** Latisha Edmonds, OFFICE ADMINISTRATOR
## Practice location
- **Address:** 101 W 2ND ST, Russellville, KY 42276
- **Phone:** (270) 881-1813 · **Fax:** (270) 886-6600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 10 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (8), Internal Medicine (1), Pulmonary Disease (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 15, 2018
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003327412) · Data from the CMS NPPES public registry.