JEFFERSONVILLE INTEGRATIVE CLINIC LLC - NPI 1861219644 - Family Medicine in Jeffersonville, IN

Q: What is Jeffersonville Integrative Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Jeffersonville Integrative Clinic Llc NPPES

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

JEFFERSONVILLE INTEGRATIVE CLINIC LLC (NPI 1861219644) is a healthcare organization registered as a family medicine in Jeffersonville, Indiana and active in the NPI registry since September 2024. The organization holds a CLIA Waiver certificate valid through July 10, 2027 and lists Rickey Dale Kinzey, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1861219644

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameJEFFERSONVILLE INTEGRATIVE CLINIC LLC

Location Address300 SPRING ST STE 3CJeffersonville, IN 47130-3498

Mailing Address300 Spring St Ste CJeffersonville, IN 47130-3385 · (812) 503-4304 · Fax (812) 954-0576

Phone(812) 503-4304

Fax(812) 954-0576

Organization SubpartNo

Authorized OfficialRickey Dale KinzeyProvider/owner · (812) 503-4304

Enumeration DateSeptember 24, 2024

Last NPPES UpdateMarch 26, 20264 updates tracked since enumeration

NPPES CertifiedMarch 26, 2026

✔ NPI 1861219644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

300 SPRING ST STE 3C, Jeffersonville, IN 47130

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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 15D2326919

Jeffersonville Integrative Clinic · Jeffersonville, IN

Active · expires Jul 10, 2027

CLIA Number15D2326919

Laboratory TypePhysician Office

Certificate Effective DateJuly 11, 2025

Certificate Expiration DateJuly 10, 2027

Laboratory DirectorRickey D. Kinzey

Laboratory Phone(812) 503-4304

Laboratory LocationJeffersonville Integrative Clinic300 Spring St Ste C, Jeffersonville, IN 47130

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Jeffersonville Integrative Clinic LLC's NPI number?

The NPI number for Jeffersonville Integrative Clinic LLC is 1861219644. It was assigned to this organization in the NPPES registry on September 24, 2024.

Where is Jeffersonville Integrative Clinic LLC located?

Jeffersonville Integrative Clinic LLC is located at 300 Spring St Ste 3C, Jeffersonville, IN 47130. The listed phone number is (812) 503-4304.

What is Jeffersonville Integrative Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Jeffersonville Integrative Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2326919) is associated with this NPI, valid through July 10, 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 Jeffersonville Integrative Clinic LLC was last updated on March 26, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.