Organization Active NPI

Hospitalist Medicine Physicians of Kentucky - Berea, PSC

  • Internal Medicine Physician
  • Cynthiana, KY
National Provider Identifier
1003664574
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HOSPITALIST MEDICINE PHYSICIANS OF KENTUCKY - BEREA, PSC
Practice address
1210 Ky Highway 36 E Unit 1
Cynthiana, KY 41031-7665
Phone
(615) 377-5658
NPI assigned
May 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Shannon Lagrone
Title
Director Payer Enrollment
Phone
(214) 422-5715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1210 Ky Highway 36 E Unit 1
Cynthiana, KY 41031-7665

Mailing address

5410 Maryland Way Ste 300
Brentwood, TN 37027-5339
Phone (615) 377-5658

National Provider Directory

National Provider Directory

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": "1715212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1003664574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275339",
            "telephone_number": "615-377-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 KY HIGHWAY 36 E UNIT 1",
            "city": "CYNTHIANA",
            "state": "KY",
            "postal_code": "410317665",
            "telephone_number": "615-377-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITALIST MEDICINE PHYSICIANS OF KENTUCKY - BEREA, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "LAGRONE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "DIRECTOR PAYER ENROLLMENT",
        "authorized_official_telephone_number": "214-422-5715"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cynthiana, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.