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BLUEGRASS URGENT CARE LLC
NPI 1104106954
Clinic/Center - Urgent Care in Walton, KY

Active since August 25, 2011CLIA 18D2036262 · Waiver
625 CHESTNUT DR, SUITE 106, WALTON, KY 41094(859) 485-7900(859) 485-7920 Get Directions Write a Review

NPPES record last updated: October 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 4, 2024, Sep 13, 2024, Jul 19, 2024 and 1 more (4 updates tracked since 2016).

About Bluegrass Urgent Care Llc NPPES

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

BLUEGRASS URGENT CARE LLC (NPI 1104106954) is a healthcare organization registered as an urgent care in Walton, Kentucky and active in the NPI registry since August 2011. The organization holds a CLIA Waiver certificate valid through February 5, 2028 and lists Robert So, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1104106954
Entity TypeOrganization
Primary Taxonomy261QU0200X
Legal Business NameBLUEGRASS URGENT CARE LLC
Location Address625 CHESTNUT DR, SUITE 106Walton, KY 41094-7845
Mailing Address625 Chestnut Dr, Suite 106Walton, KY 41094-7845 · (859) 485-7900 · Fax (859) 485-7920
Phone(859) 485-7900
Fax(859) 485-7920
Organization SubpartNo
Authorized OfficialRobert SoMedical Director · (859) 485-7900
Enumeration DateAugust 25, 2011
Last NPPES UpdateOctober 4, 20244 updates tracked since enumeration
NPPES CertifiedOctober 4, 2024
✔ NPI 1104106954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities
Taxonomy Code261QU0200X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
625 CHESTNUT DR, Walton, KY 41094
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Other Identifiers 8

Medicaid7100356480KY
Medicaid0111587OH
Medicaid0144553OH
Medicaid2274177OH
Medicaid7100108440KY
Medicaid7100204520KY
Medicaid7100217560KY
Medicaid7100351060KY

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

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 18D2036262

Bluegrass Urgent Care · Walton, KY
Active · expires Feb 5, 2028
CLIA Number18D2036262
Laboratory TypePhysician Office
Certificate Effective DateFebruary 6, 2026
Certificate Expiration DateFebruary 5, 2028
Laboratory DirectorDr. Robert R. So
Laboratory Phone(859) 485-7900
Laboratory LocationBluegrass Urgent Care625 Chestnut Drive, Suite 106, Walton, KY 41094
CLIA data matches this NPI record on: Address Name Phone
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.

JOSHUA A KADETZ MD
Family Medicine
625 CHESTNUT DR
WALTON, KY 41094
Boone County (859) 485-7900
RANDY KATHRYN SANZERE PA
Physician Assistant
625 CHESTNUT DR
WALTON, KY 41094
Boone County (859) 250-0507
OLIVIA SO APRN
Nurse Practitioner (Family)
625 CHESTNUT DR, STE 106
WALTON, KY 41094
Boone County (859) 485-7900

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 Bluegrass Urgent Care LLC's NPI number?

The NPI number for Bluegrass Urgent Care LLC is 1104106954. It was assigned to this organization in the NPPES registry on August 25, 2011.

Where is Bluegrass Urgent Care LLC located?

Bluegrass Urgent Care LLC is located at 625 Chestnut Dr Suite 106, Walton, KY 41094. The listed phone number is (859) 485-7900.

What is Bluegrass Urgent Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

Does Bluegrass Urgent Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2036262) is associated with this NPI, valid through February 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Bluegrass Urgent Care LLC accept?

Health plans from CareSource list Bluegrass Urgent Care LLC 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 Bluegrass Urgent Care LLC was last updated on October 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.