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ADVANCED FAMILY MEDICAL CLINIC MOUNT VERNON
NPI 1578090403
Clinic/Center - Rural Health in Somerset, KY

Active since May 23, 2017CLIA 18D2132041 · Waiver
79 SARAHS LN, SOMERSET, KY 42503(606) 687-9017(606) 655-1030 Get Directions Write a Review

NPPES record last updated: January 16, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 16, 2026, Feb 27, 2020, Mar 7, 2018 and 4 more (7 updates tracked since 2017).

About Advanced Family Medical Clinic Mount Vernon NPPES

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

ADVANCED FAMILY MEDICAL CLINIC MOUNT VERNON (NPI 1578090403), doing business as Advanced Family Medical Clinic, is a healthcare organization registered as a rural health in Somerset, Kentucky and active in the NPI registry since May 2017. The organization holds a CLIA Waiver certificate valid through June 11, 2027 and lists Khursheed Akram Siddiqui, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1578090403
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameADVANCED FAMILY MEDICAL CLINIC MOUNT VERNON
Location Address79 SARAHS LNSomerset, KY 42503-2789
Mailing AddressPo Box 2369Danville, KY 40423-2369 · (606) 392-2060 · Fax (606) 655-1030
Phone(606) 687-9017
Fax(606) 655-1030
Organization SubpartNo
Authorized OfficialKhursheed Akram SiddiquiMedical Director · (859) 691-0201
Enumeration DateMay 23, 2017
Last NPPES UpdateJanuary 16, 20267 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2026
✔ NPI 1578090403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X · License 28741 (KY)
79 SARAHS LN, Somerset, KY 42503
Open in Google Maps ↗

Other Names 1

Doing Business AsAdvanced Family Medical Clinic

Other Identifiers 1

Medicaid7100503150KY

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 MULTIPLE 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 18D2132041

Advanced Family Medical Clinic Mt Vernon Dba Advanced Family Medical Clinic · Somerset, KY
Active · expires Jun 11, 2027
CLIA Number18D2132041
Laboratory TypeRural Health Clinic
Certificate Effective DateJune 12, 2025
Certificate Expiration DateJune 11, 2027
Laboratory DirectorKhursheed A. Siddiqui
Laboratory Phone(606) 392-2060
Laboratory LocationAdvanced Family Medical Clinic Mt Vernon Dba Advanced Family Medical Clinic79 Sarahs Lane, Somerset, KY 42503
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DR. RICKY L FARMER DMD
Dentist
79 SARAHS LN
SOMERSET, KY 42503
Pulaski County (606) 677-0505

Frequently Asked Questions

What is ADVANCED FAMILY MEDICAL CLINIC MOUNT VERNON's NPI number?

The NPI number assigned to this healthcare provider is 1578090403, enumerated as an "organization" on May 23, 2017.

Where is the provider located?

The provider is located at 79 SARAHS LN SOMERSET, KY 42503 and the phone number is (606) 687-9017.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

What insurance does ADVANCED FAMILY MEDICAL CLINIC MOUNT VERNON accept?

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.