Bourbon Physician Practice LLC
NPI 1356689079 · Rural Health Clinic/Center · Carlisle, KY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Bourbon Physician Practice LLC is a Rural Health Clinic/Center organization in Carlisle, KY (NPI 1356689079).
Provider details
- NPI number
- 1356689079
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Monica Bowman, President(615) 920-7000
Specialties & taxonomies
Ambulatory Health Care Facilities
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Carlisle Clinic
- Doing business as
- Carlisle Clinic
Registry dates
- Enumerated
- 2013-01-30
- Last updated
- 2022-09-24
- Certified
- 2022-09-24
Frequently asked questions
- What is Bourbon Physician Practice LLC's NPI number?
- Bourbon Physician Practice LLC's National Provider Identifier (NPI) is 1356689079, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bourbon Physician Practice LLC?
- Bourbon Physician Practice LLC is classified in the NPPES registry as Rural Health Clinic/Center (Ambulatory Health Care Facilities).
- Where is Bourbon Physician Practice LLC located?
- Bourbon Physician Practice LLC's practice location on file with NPPES is 107 S Broadway St, Carlisle, KY 40311-1150.
- What is Bourbon Physician Practice LLC's phone number?
- The practice phone number listed in the NPPES registry for Bourbon Physician Practice LLC is (859) 289-4124.
- Does Bourbon Physician Practice LLC accept Medicare?
- Bourbon Physician Practice LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Bourbon Physician Practice LLC?
- The authorized official listed on Bourbon Physician Practice LLC's NPPES record is Monica Bowman, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bourbon Physician Practice LLC's NPI active?
- Yes — Bourbon Physician Practice LLC's NPI (1356689079) is active in the NPPES registry as of the last update on 2022-09-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.