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KIOSK MEDICINE OF KENTUCKY LLC
NPI 1063293389
Nurse Practitioner - Family in La Grange, KY

Active since October 12, 2023CLIA 18D2288793 · Waiver
2835 S HIGHWAY 393, LA GRANGE, KY 40031(502) 530-4812(502) 530-4813 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 12, 2025, May 9, 2025, Dec 11, 2024 and 1 more (4 updates tracked since 2023).

About Kiosk Medicine Of Kentucky Llc NPPES

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

KIOSK MEDICINE OF KENTUCKY LLC (NPI 1063293389) is a healthcare organization registered as a family in La Grange, Kentucky and active in the NPI registry since October 2023. The organization holds a CLIA Waiver certificate valid through August 30, 2027 and lists Thomas Shelly, Vp & General Manager, as its authorized official.

NPPES Registry Identity

NPI1063293389
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameKIOSK MEDICINE OF KENTUCKY LLC
Location Address2835 S HIGHWAY 393La Grange, KY 40031-9613
Mailing AddressPo Box 932958Cleveland, OH 44193-0028 · (615) 425-4200 · Fax (615) 425-4201
Phone(502) 530-4812
Fax(502) 530-4813
Organization SubpartNo
Authorized OfficialThomas ShellyVp & General Manager · (615) 425-4200
Enumeration DateOctober 12, 2023
Last NPPES UpdateOctober 21, 20254 updates tracked since enumeration
NPPES CertifiedOctober 21, 2025
✔ NPI 1063293389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedPhysician AssistantTaxonomy 363A00000X
2835 S HIGHWAY 393, La Grange, KY 40031
Open in Google Maps ↗

Other Identifiers 1

Medicaid7100949580KY

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

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 18D2288793

Kiosk Medicine Ky LLC #18122 · La Grange, KY
Active · expires Aug 30, 2027
CLIA Number18D2288793
Laboratory TypeWalk In Healthcare Clinic
Certificate Effective DateAugust 31, 2025
Certificate Expiration DateAugust 30, 2027
Laboratory DirectorMs. Erin Macy
Laboratory Phone(502) 530-4812
Laboratory LocationKiosk Medicine Ky LLC #181222835 S Hwy 393, La Grange, KY 40031
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

STEFFANY NICOLE NEIE RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2835 S HIGHWAY 393
LA GRANGE, KY 40031
Oldham County (502) 530-4808
MRS. TONYA LEANN MARTIN APRN, FNP-C
Nurse Practitioner (Family)
2835 S HIGHWAY 393
LA GRANGE, KY 40031
Oldham County (502) 525-0154
SUSAN KAY WHITTINGTON APRN
Nurse Practitioner (Family)
2835 S HIGHWAY 393
LA GRANGE, KY 40031
Oldham County (502) 530-4812
KROGER LIMITED PARTNERSHIP I
Pharmacy (Community/Retail Pharmacy)
2835 S HIGHWAY 393
LA GRANGE, KY 40031
Oldham County (502) 530-4808
JOSHUA LAKE RICHARDSON
Pharmacist
2835 S HIGHWAY 393
LA GRANGE, KY 40031
Oldham County (502) 530-4808

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 Kiosk Medicine Of Kentucky LLC's NPI number?

The NPI number for Kiosk Medicine Of Kentucky LLC is 1063293389. It was assigned to this organization in the NPPES registry on October 12, 2023.

Where is Kiosk Medicine Of Kentucky LLC located?

Kiosk Medicine Of Kentucky LLC is located at 2835 S Highway 393, La Grange, KY 40031. The listed phone number is (502) 530-4812.

What is Kiosk Medicine Of Kentucky LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Kiosk Medicine Of Kentucky LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2288793) is associated with this NPI, valid through August 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kiosk Medicine Of Kentucky LLC was last updated on October 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.