COUNTRYSIDE FAMILY CARE
NPI 1083146633
Nurse Practitioner - Family in Hartford, KY

Active since April 03, 2017CLIA 18D2132459 · Waiver
1041 US HIGHWAY 231 N, HARTFORD, KY 42347(270) 233-2024(270) 233-0202 Get Directions Write a Review

NPPES record last updated: April 3, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Countryside Family Care NPPES

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

COUNTRYSIDE FAMILY CARE (NPI 1083146633) is a healthcare organization registered as a family in Hartford, Kentucky and active in the NPI registry since April 2017. The organization holds a CLIA Waiver certificate valid through June 19, 2027 and lists Elaine M Berry, Offcie Manager, as its authorized official.

NPPES Registry Identity

NPI1083146633
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameCOUNTRYSIDE FAMILY CARE
Location Address1041 US HIGHWAY 231 NHartford, KY 42347-9402
Mailing AddressPo Box 585Hartford, KY 42347-0585 · (270) 233-2024 · Fax (270) 233-0202
Fax(270) 233-0202
Organization SubpartNo
Authorized OfficialElaine M BerryOffcie Manager · (270) 233-2024
Enumeration DateApril 3, 2017
NPI 1083146633 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in KY · 3008378
1041 US HIGHWAY 231 N, Hartford, KY 42347

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 18D2132459

Countryside Family Care · Hartford, KY
Active · expires Jun 19, 2027
CLIA Number18D2132459
Laboratory TypePhysician Office
Certificate Effective DateJune 20, 2025
Certificate Expiration DateJune 19, 2027
Laboratory DirectorDana Brianne Milligan
Laboratory Phone(270) 504-7060
Laboratory LocationCountryside Family Care1133 South Main Street, Hartford, KY 42347
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

Nurse Practitioner (Family)
1041 US HIGHWAY 231 N
HARTFORD, KY 42347
Nurse Practitioner (Family)
1041 US HIGHWAY 231 N
HARTFORD, KY 42347
Chiropractor
1041 US HIGHWAY 231 N
HARTFORD, KY 42347

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 Countryside Family Care's NPI number?

The NPI number for Countryside Family Care is 1083146633. It was assigned to this organization in the NPPES registry on April 3, 2017.

Where is Countryside Family Care located?

Countryside Family Care is located at 1041 Us Highway 231 N, Hartford, KY 42347. The listed phone number is (270) 233-2024.

What is Countryside Family Care's specialty?

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

Does Countryside Family Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2132459) is associated with this NPI, valid through June 19, 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 Countryside Family Care was last updated on April 3, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.