Organization Active NPI

Thomas P. Von Unrug MD Inc

  • Adolescent Medicine (Internal Medicine) Physician
  • Lexington, KY
National Provider Identifier
1003134537
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
31364 Issued in KY
Legal business name
THOMAS P. VON UNRUG MD INC
Practice address
1401 Harrodsburg Rd Ste B299
Lexington, KY 40504-3747
Phone
(859) 276-0714
Fax
(859) 276-0363
NPI assigned
May 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas P Von Unrug, M.D.NPI 1295779957
Title
Owner
Phone
(859) 276-0714

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RA0000X 31364 KY Primary

Addresses

Primary practice location

1401 Harrodsburg Rd Ste B299
Lexington, KY 40504-3747

Mailing address

1401 Harrodsburg Rd Ste B299
Lexington, KY 40504-3747
Phone (859) 276-0714

Other identifiers 1

IdentifierTypeStateIssuer
64313646MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thomasvonunrug@dtpu.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100617000511 KY Part B Supplier - Clinic/Group Practice 0840320891 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0933665Thomas P Von Unrug MD Inc1401 Harrodsburg Road Suite B-299, Lexington, KY 40504Provider-performed microscopySep 17, 2027

National Provider Directory

National Provider Directory

Locations

700 Mason Headley Rd
Lexington, KY 40504
Phone (859) 259-3486

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1003134537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD STE B299",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043747",
            "telephone_number": "859-276-0714",
            "fax_number": "859-276-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD STE B299",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043747",
            "telephone_number": "859-276-0714",
            "fax_number": "859-276-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS P. VON UNRUG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-07",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "VON UNRUG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-276-0714",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "KY",
            "license": "31364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64313646",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomasvonunrug@dtpu.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Allscripts Direct Interface",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1401 Harrodsburg Rd Ste B299",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405043747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.