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KIOSK MEDICINE OF KENTUCKY LLC
NPI 1578956884
Nurse Practitioner - Family in Independence, KY

Active since March 11, 2015CLIA 18D2090503 · Waiver
1700 DECLARATION DR, INDEPENDENCE, KY 41051(859) 898-1608(859) 898-1609 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 12, 2025, Dec 12, 2024, Jun 13, 2018 and 1 more (4 updates tracked since 2016).

About Kiosk Medicine Of Kentucky Llc NPPES

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

KIOSK MEDICINE OF KENTUCKY LLC (NPI 1578956884) is a healthcare organization registered as a family in Independence, Kentucky and active in the NPI registry since March 2015. The organization holds a CLIA Waiver certificate valid through January 25, 2027 and lists Thomas Shelly, Vp & General Manager, as its authorized official.

NPPES Registry Identity

NPI1578956884
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameKIOSK MEDICINE OF KENTUCKY LLC
Location Address1700 DECLARATION DRIndependence, KY 41051-8441
Mailing AddressPo Box 932958Cleveland, OH 44193-0028 · (615) 425-4200 · Fax (615) 425-4201
Phone(859) 898-1608
Fax(859) 898-1609
Organization SubpartNo
Authorized OfficialThomas ShellyVp & General Manager · (615) 425-4200
Enumeration DateMarch 11, 2015
Last NPPES UpdateOctober 21, 20254 updates tracked since enumeration
NPPES CertifiedOctober 21, 2025
✔ NPI 1578956884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedPhysician AssistantTaxonomy 363A00000X
1700 DECLARATION DR, Independence, KY 41051
Open in Google Maps ↗

Other Identifiers 1

Medicaid7100386210KY

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

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 18D2090503

Kiosk Medicine Ky LLC · Independence, KY
Active · expires Jan 25, 2027
CLIA Number18D2090503
Laboratory TypeWalk In
Certificate Effective DateJanuary 26, 2025
Certificate Expiration DateJanuary 25, 2027
Laboratory DirectorMs. Theresa Riggs
Laboratory Phone(859) 898-1608
Laboratory LocationKiosk Medicine Ky LLC1700 Declaration Drive, Independence, KY 41051
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

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

BRANDY SULLIVAN BRANHAM FNP
Nurse Practitioner (Family)
1700 DECLARATION DR
INDEPENDENCE, KY 41051
Kenton County (859) 898-1608
ASHLEY MARIE ESTEPP PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1700 DECLARATION DR
INDEPENDENCE, KY 41051
Kenton County (859) 898-1620
DR. BRIAN WESSELMAN PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1700 DECLARATION DR
INDEPENDENCE, KY 41051
Kenton County (859) 898-1620
ALEXANDRA NUNEZ
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1700 DECLARATION DR
INDEPENDENCE, KY 41051
Kenton County (859) 898-1620
PAIGE WARNING
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1700 DECLARATION DR
INDEPENDENCE, KY 41051
Kenton County (859) 898-1620
MICHELLE FLYNN RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1700 DECLARATION DR
INDEPENDENCE, KY 41051
Kenton County (859) 898-1620
HEIDI HAYES
Pharmacist
1700 DECLARATION DR
INDEPENDENCE, KY 41051
Kenton County (859) 898-1620
KATHLEEN DIETRICH PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1700 DECLARATION DR
INDEPENDENCE, KY 41051
Kenton County (859) 898-1620

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 Kiosk Medicine Of Kentucky LLC's NPI number?

The NPI number for Kiosk Medicine Of Kentucky LLC is 1578956884. It was assigned to this organization in the NPPES registry on March 11, 2015.

Where is Kiosk Medicine Of Kentucky LLC located?

Kiosk Medicine Of Kentucky LLC is located at 1700 Declaration Dr, Independence, KY 41051. The listed phone number is (859) 898-1608.

What is Kiosk Medicine Of Kentucky LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Kiosk Medicine Of Kentucky LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2090503) is associated with this NPI, valid through January 25, 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 Kiosk Medicine Of Kentucky LLC was last updated on October 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.