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EP MEDICAL LLC
NPI 1235863218
Nurse Practitioner in Campbellsville, KY

Active since July 14, 2022CLIA 18D2316978 · Waiver
500 N BYPASS RD STE C, CAMPBELLSVILLE, KY 42718(270) 789-0577(270) 789-0578 Get Directions Write a Review

NPPES record last updated: April 18, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 18, 2024, Jul 14, 2022 (2 updates tracked since 2022).

About Ep Medical Llc NPPES

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

EP MEDICAL LLC (NPI 1235863218) is a healthcare organization registered as a nurse practitioner in Campbellsville, Kentucky and active in the NPI registry since July 2022. The organization holds a CLIA Waiver certificate valid through January 15, 2027 and lists John R Eastridge, Owner/authorized Official, as its authorized official.

NPPES Registry Identity

NPI1235863218
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameEP MEDICAL LLC
Location Address500 N BYPASS RD STE CCampbellsville, KY 42718-7792
Mailing Address500 N Bypass Rd Ste CCampbellsville, KY 42718-7792 · (270) 789-0577 · Fax (270) 789-0578
Phone(270) 789-0577
Fax(270) 789-0578
Organization SubpartNo
Authorized OfficialJohn R EastridgeOwner/authorized Official · (270) 403-9333
Enumeration DateJuly 14, 2022
Last NPPES UpdateApril 18, 20242 updates tracked since enumeration
NPPES CertifiedApril 18, 2024
✔ NPI 1235863218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
500 N BYPASS RD STE C, Campbellsville, KY 42718
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ep Medical Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Ep Medical LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Maci Mcqueary, APRN
Nurse Practitioner
NPI 1104430297
410 HOTCHKISS ST
Campbellsville, KY 42718
(270) 465-0191
✔ PECOS✔ Accepts Medicare1.0 mi
Pavel Conovalciuc, MD
Family Practice
NPI 1720017080
1502 N VERCLER RD
Spokane Valley, WA 99216
(509) 444-8204
✔ PECOS✔ Accepts Medicare1,761 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 18D2316978

Ep Medical LLC · Campbellsville, KY
Active · expires Jan 15, 2027
CLIA Number18D2316978
Laboratory TypePharmacy
Certificate Effective DateJanuary 16, 2025
Certificate Expiration DateJanuary 15, 2027
Laboratory DirectorMr. John R. Eastridge
Laboratory Phone(270) 789-0577
Laboratory LocationEp Medical LLC500 N Bypass, Ste C, Campbellsville, KY 42718
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Ep Medical LLC's NPI number?

The NPI number for Ep Medical LLC is 1235863218. It was assigned to this organization in the NPPES registry on July 14, 2022.

Where is Ep Medical LLC located?

Ep Medical LLC is located at 500 N Bypass Rd Ste C, Campbellsville, KY 42718. The listed phone number is (270) 789-0577.

What is Ep Medical LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Ep Medical LLC enrolled in Medicare?

Yes. Ep Medical LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ep Medical LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Ep Medical LLC, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Ep Medical LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2316978) is associated with this NPI, valid through January 15, 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 Ep Medical LLC was last updated on April 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.