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NPI Code Detail

MEDICARE: CASEY MEDICAL PRACTICE LLC

MEDICARE: CASEY MEDICAL PRACTICE 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
1207R00000XInternal Medicine Physician
2363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1558212217
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASEY MEDICAL PRACTICE LLC
Provider Business Mailing Address
First Line : 430 E PLEASANT ST
Second Line :
City : CYNTHIANA
State : KY
Zip : 41031-1816
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 430 E PLEASANT ST
Second Line :
City : CYNTHIANA
State : KY
Zip : 41031-1816
Country : US
Telephone Number : 859-234-3282
Fax Number : 859-234-9400
Authorized Official
Title or Position : OWNER
Name : VICKEY L CASEY
Credential : APRN
Telephone Number : 859-588-6768
Provider Enumeration Date : 02/06/2026
Last Update Date : 02/06/2026

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Directions to “CASEY MEDICAL PRACTICE LLC ” Practice Location

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