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GEORGETOWN INTERNAL MEDICINE
NPI 1730533209
Physician Assistant - Medical in Georgetown, KY

Active since April 20, 2016CLIA 18D0692547 · Waiver
200 BEVINS LN STE A, GEORGETOWN, KY 40324(502) 863-0722(502) 863-0731 Get Directions Write a Review

NPPES record last updated: August 1, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 7, 2023, Jun 6, 2019 (2 updates tracked since 2019).

About Georgetown Internal Medicine NPPES

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

GEORGETOWN INTERNAL MEDICINE (NPI 1730533209) is a healthcare organization registered as a medical in Georgetown, Kentucky and active in the NPI registry since April 2016. The organization holds a CLIA Waiver certificate valid through August 31, 2027 and lists Patricia A King, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1730533209
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameGEORGETOWN INTERNAL MEDICINE
Location Address200 BEVINS LN STE AGeorgetown, KY 40324-8532
Mailing Address200 Bevins Ln Ste AGeorgetown, KY 40324-8532 · (502) 863-0722 · Fax (502) 863-0731
Phone(502) 863-0722
Fax(502) 863-0731
Organization SubpartNo
Authorized OfficialPatricia A KingPractice Manager · (502) 863-0722
Enumeration DateApril 20, 2016
Last NPPES UpdateAugust 1, 20252 updates tracked since enumeration
NPPES CertifiedAugust 1, 2025
✔ NPI 1730533209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
200 BEVINS LN STE A, Georgetown, KY 40324
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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

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 18D0692547

Georgetown Internal Medicine · Georgetown, KY
Active · expires Aug 31, 2027
CLIA Number18D0692547
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2025
Certificate Expiration DateAugust 31, 2027
Laboratory DirectorDr. Benjamin P. Lyon
Laboratory Phone(502) 863-0722
Laboratory LocationGeorgetown Internal Medicine200 Bevins Lane, Suite A, Georgetown, KY 40324
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 3

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

MS. MANDY R MYNHIER PA-C
Physician Assistant (Medical)
200 BEVINS LN STE A
GEORGETOWN, KY 40324
Scott County (502) 863-0722
ALISON R WINGER LPCC
Counselor (Mental Health)
200 BEVINS LN STE A
GEORGETOWN, KY 40324
Scott County (859) 951-9777
BENJAMIN P LYON M.D.
Internal Medicine
200 BEVINS LN STE A
GEORGETOWN, KY 40324
Scott County (502) 863-0722

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 Georgetown Internal Medicine's NPI number?

The NPI number for Georgetown Internal Medicine is 1730533209. It was assigned to this organization in the NPPES registry on April 20, 2016.

Where is Georgetown Internal Medicine located?

Georgetown Internal Medicine is located at 200 Bevins Ln Ste A, Georgetown, KY 40324. The listed phone number is (502) 863-0722.

What is Georgetown Internal Medicine's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Does Georgetown Internal Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D0692547) is associated with this NPI, valid through August 31, 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 Georgetown Internal Medicine was last updated on August 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.