Organization
KIOSK MEDICINE KENTUCKY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS SHELLY (VP & GENERAL MANAGER)
(615) 425-4200
Entity
Organization
Contact information
Practice address
90 STONEGATE CTR, SOMERSET, KY 42501-6212
(606) 451-4425
(606) 451-4426
Mailing address
1014 VINE ST, CINCINNATI, OH 45202-1141
(615) 425-4200
(615) 425-4201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205885035
GROUP NPI
KY
Enumeration date
09/14/2016
Last updated
10/21/2025
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