STANFORD WELLCARE CLINIC PLLC
NPI 1861071219
Clinic/Center - Rural Health in Stanford, KY
About Stanford Wellcare Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STANFORD WELLCARE CLINIC PLLC (NPI 1861071219) is a healthcare organization registered as a rural health in Stanford, Kentucky and active in the NPI registry since April 2021. The organization holds a CLIA Waiver certificate valid through May 2, 2027 and lists Imad A Haddad, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stanford Wellcare Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Stanford Wellcare Clinic PLLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 18D2222976
Stanford Wellcare Clinic, PLLC · Stanford, KYFrequently 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 Stanford Wellcare Clinic PLLC's NPI number?
The NPI number for Stanford Wellcare Clinic PLLC is 1861071219. It was assigned to this organization in the NPPES registry on April 5, 2021.
Where is Stanford Wellcare Clinic PLLC located?
Stanford Wellcare Clinic PLLC is located at 132 Frontier Blvd Ste 101, Stanford, KY 40484. The listed phone number is (606) 727-5757.
What is Stanford Wellcare Clinic PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Stanford Wellcare Clinic PLLC enrolled in Medicare?
Yes. Stanford Wellcare Clinic PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Stanford Wellcare Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Stanford Wellcare Clinic PLLC, in Internal Medicine and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Stanford Wellcare Clinic PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 18D2222976) is associated with this NPI, valid through May 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Stanford Wellcare Clinic PLLC accept?
Health plans from Anthem Blue Cross and Blue Shield list Stanford Wellcare Clinic PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Stanford Wellcare Clinic PLLC was last updated on August 3, 2021. 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.
# Stanford Wellcare Clinic Pllc · NPI 1861071219
Rural Health organization in Stanford, Kentucky. Organization record, active in the CMS NPPES registry since April 5, 2021.
## Identity
- **NPI:** 1861071219 (Entity type: Organization)
- **Enumerated:** April 5, 2021
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Organization subpart:** No
- **Authorized official:** Imad Haddad, OWNER
## Practice location
- **Address:** 132 FRONTIER BLVD STE 101, Stanford, KY 40484-6516
- **Phone:** (606) 727-5757 · **Fax:** (606) 727-5777
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (1), Nurse Practitioner (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 3, 2021
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1861071219) · Data from the CMS NPPES public registry.