{"npi":"1205935814","type":"NPI-2","status":"active","name":{"display":"Means Adult Primary Care Clinic Of Kentucky PLLC","other":[],"organization_name":"MEANS ADULT PRIMARY CARE CLINIC OF KENTUCKY PLLC","authorised_official":"Rezkalla Butros"},"specialty":{"primary_taxonomy":"261QR1300X","primary_taxonomy_description":"Rural Health Clinic/Center","slug":"rural-health-clinic-center","schema_org_specialty":null,"all":[{"code":"261QR1300X","description":"Rural Health Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"148 SKYVIEW DR.","city":"MT STERLING","state":"KY","postal_code":"403531300","country_code":"US","phone":"8594990717","fax":"8594990926"},{"purpose":"MAILING","street_1":"148 SKYVIEW DR","city":"MT STERLING","state":"KY","postal_code":"403531496","country_code":"US","phone":"8594990717","fax":"8594990926"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"7100636790","state":"KY","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20031218000659","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"KY","pac_id":"5395642177"},{"enrlmt_id":"O20190812002291","type_code":"00-17","type_desc":"PART A PROVIDER - RURAL HEALTH CLINIC","state":"KY","pac_id":"5395642177"}]},"enumeration_date":"2006-09-21","last_updated":"2024-05-10","_meta":{"source":"NPPES","snapshot_date":"2024-05-10","doc_url":"https://findmynpi.com/api"}}