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MINDCLUB KENTUCKY LLC
NPI 1033005079
Nurse Practitioner - Primary Care in Hopkinsville, KY

Active since June 16, 2025
111 DERRICK PL, HOPKINSVILLE, KY 42240(833) 833-9655 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mindclub Kentucky Llc NPPES

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

MINDCLUB KENTUCKY LLC (NPI 1033005079) is a healthcare organization registered as a primary care in Hopkinsville, Kentucky and active in the NPI registry since June 2025. The organization lists Kathy Richardson, Vp, Cao, as its authorized official.

NPPES Registry Identity

NPI1033005079
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameMINDCLUB KENTUCKY LLC
Location Address111 DERRICK PLHopkinsville, KY 42240-1325
Mailing Address106 Mission Ct Ste 201aFranklin, TN 37067-6441 · (153) 902-8656
Phone(833) 833-9655
Organization SubpartNo
Authorized OfficialKathy RichardsonVp, Cao · (615) 390-2865
Enumeration DateJune 16, 2025
NPPES CertifiedJune 16, 2025
✔ NPI 1033005079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
111 DERRICK PL, Hopkinsville, KY 42240
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

JILLIANS LLC
Clinic/Center (Primary Care)
111 DERRICK PL
HOPKINSVILLE, KY 42240
Christian County (270) 874-2629
AUTUMN L TRIPLETT APRN
Nurse Practitioner (Family)
111 DERRICK PL
HOPKINSVILLE, KY 42240
Christian County (270) 874-2629
TRIPCO MEDICAL LLC
Nurse Practitioner (Family)
111 DERRICK PL
HOPKINSVILLE, KY 42240
Christian County (270) 874-2629
JILL ANNE MORGAN APRN
Nurse Practitioner (Primary Care)
111 DERRICK PL
HOPKINSVILLE, KY 42240
Christian County (270) 874-2629

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 Mindclub Kentucky LLC's NPI number?

The NPI number for Mindclub Kentucky LLC is 1033005079. It was assigned to this organization in the NPPES registry on June 16, 2025.

Where is Mindclub Kentucky LLC located?

Mindclub Kentucky LLC is located at 111 Derrick Pl, Hopkinsville, KY 42240. The listed phone number is (833) 833-9655.

What is Mindclub Kentucky LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Mindclub Kentucky LLC was last updated on June 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.