ADVANCED FAMILY MEDICAL CLINIC LIBERTY – Rural Health Clinic/Center, NPI 1023545241

ADVANCED FAMILY MEDICAL CLINIC LIBERTY is a healthcare provider. based in Liberty, Kentucky. specializing in Rural Health Clinic/Center. The organization holds a License No. 28741 (KY). The NPI Number for ADVANCED FAMILY MEDICAL CLINIC LIBERTY is 1023545241

Main info

Organization
Name
ADVANCED FAMILY MEDICAL CLINIC LIBERTY
NPI
1023545241
Phone
(606) 303-9011
Address
84 HUSTONVILLE ST
Authorized Official
DR. KHURSHEED AKRAM SIDDIQUI MEDICAL DIRECTOR MD
Enumeration Date
18 May 2017
Last Update Date
16 January 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:9State licenses:1Digital endpointsOther names

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Provider Addresses for ADVANCED FAMILY MEDICAL CLINIC LIBERTY

  • 84, Hustonville Street, Liberty, Casey County, Kentucky, 42539, United States

    LIBERTY, KY 425393469

    Phone: (606) 303-9011

    Fax: (606) 303-9170

    Type: Mailing

  • PO BOX 2369

    DANVILLE, KY 404232369

    Phone: (606) 303-9011

    Fax: (606) 303-9170

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-10-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-07-31 (1046 days ago).

Enrollment records

2

Earliest due date

2023-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20170620000387ORural Health ClinicKY2023-07-31
O20171026003580OClinic/Group PracticeKYTBD

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 42539)

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Reviews

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Frequently asked questions

How is ADVANCED FAMILY MEDICAL CLINIC LIBERTY identified in CMS data?
CMS-hosted NPPES data lists ADVANCED FAMILY MEDICAL CLINIC LIBERTY with NPI 1023545241.
Does CMS list ADVANCED FAMILY MEDICAL CLINIC LIBERTY as active?
Yes — ADVANCED FAMILY MEDICAL CLINIC LIBERTY is active in the NPI listing used on this page.
What is ADVANCED FAMILY MEDICAL CLINIC LIBERTY best known for clinically?
Directory data describes ADVANCED FAMILY MEDICAL CLINIC LIBERTY with Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
What address line appears for ADVANCED FAMILY MEDICAL CLINIC LIBERTY?
ADVANCED FAMILY MEDICAL CLINIC LIBERTY's geographic hint is Liberty, Kentucky in our summary view.
Is the information about ADVANCED FAMILY MEDICAL CLINIC LIBERTY up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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