FORT LOGAN WALK-IN & PRIMARY CARE
NPI 1386799757
Family Medicine in Stanford, KY

Q: What is Ephraim Mcdowell Health Resource, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since January 24, 2007CLIA 18D0968439 · Waiver

110 METKER TRL, STANFORD, KY 40484(606) 365-3360 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Fort Logan Walk-in & Primary Care NPPES

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

FORT LOGAN WALK-IN & PRIMARY CARE (NPI 1386799757) is a healthcare organization registered as a family medicine in Stanford, Kentucky and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through January 25, 2028 and lists Amanda Kinman, Cfo, as its authorized official.

NPPES Registry Identity

NPI1386799757

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameEPHRAIM MCDOWELL HEALTH RESOURCE, INC.

Location Address110 METKER TRLStanford, KY 40484-1065

Mailing AddressPo Box 990Danville, KY 40423-0990 · (859) 239-2379

Phone(606) 365-3360

Organization SubpartNo

Authorized OfficialAmanda KinmanCfo · (859) 239-2424

Enumeration DateJanuary 24, 2007

Last NPPES UpdateDecember 30, 2021

NPPES CertifiedDecember 30, 2021

✔ NPI 1386799757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in KY · 900145

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

110 METKER TRL, Stanford, KY 40484

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Other Names 1

Doing Business AsFort Logan Walk-in & Primary Care

Other Identifiers 1

Medicaid35001478KY

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.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 18D0968439

Fort Logan Walk-In & Primary Care · Stanford, KY

Active · expires Jan 25, 2028

CLIA Number18D0968439

Laboratory TypeCommunity Clinic

Certificate Effective DateJanuary 26, 2026

Certificate Expiration DateJanuary 25, 2028

Laboratory DirectorMs. Gail Smothers

Laboratory Phone(606) 365-3360

Laboratory LocationFort Logan Walk-In & Primary Care110 Metker Trail, Stanford, KY 40484

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 23

Medicare supplier enrollment and the product categories Medsource Of Stanford carries, from the Medicare DMEPOS supplier directory.

Medsource Of Stanford

DMEPOS supplier · Stanford, KYOperated by Ephraim Mcdowell Regional Medical Center Incorporated

✔

Accepts Medicare assignment

Medsource Of Stanford agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20677295

Medicare Participant SinceOctober 1, 1985

Supplier Location110 Metker TrlStanford, KY 40484

Phone(606) 365-4632

Supplier Specialties

Medical Supply Company Other MSC With Respiratory Therapist MSC With Prosthetic Personnel

Medicare Product Categories

Commodes, Urinals, Bedpans

Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals

Contracture Treatment Devices: Dynamic Splint

Dynamic splinting devices for the knee, elbow, wrist, finger, or toe

Heat & Cold Applications

Heat therapy, Cold therapy, Heating pads

Hospital Beds (Electric)

Total electric hospital beds, Semi-electric hospital beds

Pneumatic Compression Devices and/or Supplies

Pnuematic compressor, Arm pneumatic appliance, Leg pneumatic appliance

Support Surfaces: Pressure Reducing Beds/Mats/Pads

Group 1 – Alternating pressure pad, Air/Water/Dry pressure pad or pressure mattress. Group 2 - Pressure reducing powered air mattresses, Powered air flotation bed, non-powered pressure reducing mattress Group 3 – Air fluidized bed

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 9

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

EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INCORPORATED

Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)