Main Street Medical Clinic
NPI 1952180408ActiveOrganization· Nurse Practitioner, Family· Grayson, KY
Nurse Practitioner, Family in Grayson, Kentucky, registered in NPPES in September 2023. The authorized official on file is Stacy Holley, APRN, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1952180408 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 25, 2023 |
| Last updated in NPPES | Sep 25, 2023 |
| Certified by provider | Sep 25, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (KY) |
|---|
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