LILY CREEK MEDICAL GROUP, PSC
NPI 1205987542
Internal Medicine in Russell Springs, KY

Active since January 15, 2007
92 JOE T PETTY DR, RUSSELL SPRINGS, KY 42642(270) 866-8881(270) 866-8849 Get Directions Write a Review

NPPES record last updated: October 30, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lily Creek Medical Group, Psc NPPES

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

LILY CREEK MEDICAL GROUP, PSC (NPI 1205987542) is a healthcare organization registered as an internal medicine in Russell Springs, Kentucky and active in the NPI registry since January 2007. The organization lists Robert L. Bertram, President, as its authorized official.

NPPES Registry Identity

NPI1205987542
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLILY CREEK MEDICAL GROUP, PSC
Location Address92 JOE T PETTY DRRussell Springs, KY 42642-8543
Mailing AddressPo Box 5007Frankfort, KY 40602-5007 · (502) 226-3858 · Fax (502) 223-9829
Fax(270) 866-8849
Organization SubpartNo
Authorized OfficialRobert L. BertramPresident · (270) 866-8881
Enumeration DateJanuary 15, 2007
Last NPPES UpdateOctober 30, 2008
NPI 1205987542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedNurse PractitionerTaxonomy 363L00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
92 JOE T PETTY DR, Russell Springs, KY 42642

Other Identifiers 4

Medicare ID-Type Unspecified7275KY
Other000000064586KY · Anthem
Medicaid65932386KY
Other608475500KY · Black Lung

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 10

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

Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
92 JOE T PETTY DR, SUITE 700
RUSSELL SPRINGS, KY 42642
Clinic/Center (Rural Health)
92 JOE T PETTY DR
RUSSELL SPRINGS, KY 42642
Internal Medicine
92 JOE T PETTY DR
RUSSELL SPRINGS, KY 42642
Urology
92 JOE T PETTY DR
RUSSELL SPRINGS, KY 42642
Family Medicine
92 JOE T PETTY DR, SUITE 300
RUSSELL SPRINGS, KY 42642
Nurse Practitioner (Family)
92 JOE T PETTY DR
RUSSELL SPRINGS, KY 42642
Pharmacy (Community/Retail Pharmacy)
92 JOE T PETTY DR, STE 100
RUSSELL SPRINGS, KY 42642
Nurse Practitioner (Family)
92 JOE T PETTY DR, SUITE 400
RUSSELL SPRINGS, KY 42642

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 Lily Creek Medical Group, Psc's NPI number?

The NPI number for Lily Creek Medical Group, Psc is 1205987542. It was assigned to this organization in the NPPES registry on January 15, 2007.

Where is Lily Creek Medical Group, Psc located?

Lily Creek Medical Group, Psc is located at 92 Joe T Petty Dr, Russell Springs, KY 42642. The listed phone number is (270) 866-8881.

What is Lily Creek Medical Group, Psc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Lily Creek Medical Group, Psc was last updated on October 30, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.