CLAY CITY PEDIATRICS, PSC
Complete NPI Record 1396048872
Clinic/Center - Primary Care in Clay City, KY
Active since December 06, 2010CLIA 18D2016278 · Waiver
Complete NPI Dataset
This page contains the complete raw NPPES record for Clay City Pediatrics, Psc (NPI 1396048872), a clinic/center organization in Clay City, KY. All 30 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1396048872 Field 1/30
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/30
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/30
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: CLAY CITY PEDIATRICS, PSC Field 4/30
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: PO BOX 280 Field 5/30
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: PRESTONSBURG Field 6/30
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: KY Field 7/30
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 416530280 Field 8/30
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/30
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 6063498100 Field 10/30
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 6063498150 Field 11/30
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 98 RIVER ST Field 12/30
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: CLAY CITY Field 13/30
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: KY Field 14/30
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 403121314 Field 15/30
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 16/30
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 6066637788 Field 17/30
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 6066637785 Field 18/30
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: CAIN Field 21/30
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: STACEY Field 22/30
- The first name of the authorized official.
- Authorized Official Title or Position: PRACTICE MANAGER Field 23/30
- The title or position of the authorized official.
- Authorized Official Telephone Number: 6066637788 Field 24/30
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 261QP2300X Field 25/30
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 700222 Field 26/30
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: KY Field 27/30
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 28/30
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: N Field 29/30
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
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