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NPI Code Detail

MEDICARE: BLUEGRASS ADVANCED PRIMARY CARE LLC

MEDICARE: BLUEGRASS ADVANCED PRIMARY CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QG0300XGeriatric Medicine (Family Medicine) Physician
2207QH0002XHospice and Palliative Medicine (Family Medicine) Physician
3207R00000XInternal Medicine Physician
4207RG0300XGeriatric Medicine (Internal Medicine) Physician
5363L00000XNurse Practitioner
6207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1164381851
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUEGRASS ADVANCED PRIMARY CARE LLC
Provider Business Mailing Address
First Line : 1733 HARRODSBURG RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-3617
Country : US
Telephone Number : 855-492-0812
Fax Number : 859-296-6831
Provider Business Practice Location Address
First Line : 1733 HARRODSBURG RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-3617
Country : US
Telephone Number : 855-492-0812
Fax Number : 859-296-6831
Authorized Official
Title or Position : CHIEF LEGAL OFFICER
Name : LYNN FIELDHOUSE
Credential : JD, CHC
Telephone Number : 502-719-8921
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “BLUEGRASS ADVANCED PRIMARY CARE LLC ” Practice Location

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