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LEITCHFIELD PEDIATRIC CLINIC P.S.C.
NPI 1558318543
Clinic/Center - Rural Health in Leitchfield, KY

Active since May 27, 2006CLIA 18D0691478 · Certificate of Compliance
901 WALLACE AVE, LEITCHFIELD, KY 42754(270) 259-5641(270) 259-5309 Get Directions Write a Review

NPPES record last updated: October 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 20, 2020, Jan 18, 2019, Apr 11, 2018 (3 updates tracked since 2018).

About Leitchfield Pediatric Clinic P.s.c. NPPES

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

LEITCHFIELD PEDIATRIC CLINIC P.S.C. (NPI 1558318543) is a healthcare organization registered as a rural health in Leitchfield, Kentucky and active in the NPI registry since May 2006. The organization holds a CLIA Certificate of Compliance certificate valid through September 19, 2026 and lists Lynn Robinson, Creditialing, as its authorized official.

NPPES Registry Identity

NPI1558318543
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameLEITCHFIELD PEDIATRIC CLINIC P.S.C.
Location Address901 WALLACE AVELeitchfield, KY 42754-1417
Mailing Address901 Wallace AveLeitchfield, KY 42754-1417 · (270) 259-5641 · Fax (270) 259-5309
Phone(270) 259-5641
Fax(270) 259-5309
Organization SubpartNo
Authorized OfficialLynn RobinsonCreditialing · (270) 259-5641
Enumeration DateMay 27, 2006
Last NPPES UpdateOctober 20, 20203 updates tracked since enumeration
NPPES CertifiedOctober 20, 2020
✔ NPI 1558318543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedPediatricsTaxonomy 208000000X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
901 WALLACE AVE, Leitchfield, KY 42754
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Other Identifiers 1

Medicaid65926883KY

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

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 Compliance 18D0691478

Leitchfield Pediatric Clinic Psc · Leitchfield, KY
Active · expires Sep 19, 2026
CLIA Number18D0691478
Laboratory TypeRural Health Clinic
Certificate Effective DateSeptember 20, 2024
Certificate Expiration DateSeptember 19, 2026
Laboratory DirectorMr. Matt W. Smith
Laboratory Phone(270) 259-5641
Laboratory LocationLeitchfield Pediatric Clinic Psc901 Wallace Avenue, Leitchfield, KY 42754
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 8

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

MS. WENDEE MARIE EMBRY MS, PA-C
Pediatrics
901 WALLACE AVE
LEITCHFIELD, KY 42754
Grayson County (270) 259-5641
LAURA HUNT APRN
Nurse Practitioner (Pediatrics)
901 WALLACE AVE
LEITCHFIELD, KY 42754
Grayson County (270) 259-5641
JOSEPH MARION LEE M.D.
Pediatrics
901 WALLACE AVE
LEITCHFIELD, KY 42754
Grayson County (270) 259-5641
JESSIKA YOUNG PURCELL DO
Pediatrics
901 WALLACE AVE
LEITCHFIELD, KY 42754
Grayson County (270) 259-5641
JEANETTE MARIE JACOBS APRN
Pediatrics
901 WALLACE AVE
LEITCHFIELD, KY 42754
Grayson County (270) 259-5641
CRYSTAL BURDEN APRN
Nurse Practitioner (Pediatrics)
901 WALLACE AVE
LEITCHFIELD, KY 42754
Grayson County (270) 259-5641
JOHN EDWARD EVANS M.D.
Pediatrics
901 WALLACE AVE
LEITCHFIELD, KY 42754
Grayson County (270) 259-5641
DR. ANTHONY KURT SMITH D.O.
Pediatrics
901 WALLACE AVE
LEITCHFIELD, KY 42754
Grayson County (270) 259-5641

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 Leitchfield Pediatric Clinic P.S.C.'s NPI number?

The NPI number for Leitchfield Pediatric Clinic P.S.C. is 1558318543. It was assigned to this organization in the NPPES registry on May 27, 2006.

Where is Leitchfield Pediatric Clinic P.S.C. located?

Leitchfield Pediatric Clinic P.S.C. is located at 901 Wallace Ave, Leitchfield, KY 42754. The listed phone number is (270) 259-5641.

What is Leitchfield Pediatric Clinic P.S.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Leitchfield Pediatric Clinic P.S.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 18D0691478) is associated with this NPI, valid through September 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Leitchfield Pediatric Clinic P.S.C. was last updated on October 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.