Tri State Medical Clinic Inc
NPI 1649370719 · Rural Health Clinic/Center · Middlesboro, KY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Tri State Medical Clinic Inc is a Rural Health Clinic/Center organization in Middlesboro, KY (NPI 1649370719).
Provider details
- NPI number
- 1649370719
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Larry Roark, Nurse Practitioner/Owner(606) 242-3100
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
19 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
- Tri-State Family Healthcare
Registry dates
- Enumerated
- 2006-09-25
- Last updated
- 2020-01-31
- Certified
- 2020-01-31
Frequently asked questions
- What is Tri State Medical Clinic Inc's NPI number?
- Tri State Medical Clinic Inc's National Provider Identifier (NPI) is 1649370719, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Tri State Medical Clinic Inc?
- Tri State Medical Clinic Inc is classified in the NPPES registry as Rural Health Clinic/Center (Ambulatory Health Care Facilities).
- Where is Tri State Medical Clinic Inc located?
- Tri State Medical Clinic Inc's practice location on file with NPPES is 3503 Cumberland Ave, Middlesboro, KY 40965-2611.
- What is Tri State Medical Clinic Inc's phone number?
- The practice phone number listed in the NPPES registry for Tri State Medical Clinic Inc is (606) 242-3100.
- Does Tri State Medical Clinic Inc accept Medicare?
- Tri State Medical Clinic Inc 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 Tri State Medical Clinic Inc?
- The authorized official listed on Tri State Medical Clinic Inc's NPPES record is Larry Roark, Nurse Practitioner/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Tri State Medical Clinic Inc's NPI active?
- Yes — Tri State Medical Clinic Inc's NPI (1649370719) is active in the NPPES registry as of the last update on 2020-01-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.