Individual provider Active NPI

Reagan Poe, PA

  • Physician Assistant
  • Paducah, KY
National Provider Identifier
1003843145
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1903 Broadway St Ste B
Paducah, KY 42001-7105
Phone
(270) 444-8183
Fax
(270) 444-8147
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1903 Broadway St Ste B
Paducah, KY 42001-7105

Mailing address

239 Mt Parkway Spur
Campton, KY 41301
Phone (606) 668-6932

Other identifiers 2

IdentifierTypeStateIssuer
95005468MedicaidKY
000000388604OtherKYANTHEM BC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050301000022 KY Practitioner - Physician Assistant 7911950126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Livwell Community Health Services, Inc.Group PAC ID 0244206712, 4 clinicians

Practice addresses (Care Compare)

1903 Broadway St
Paducah, KY 42001-7105
Phone (270) 444-8183

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
84.31
Improvement activities
40
Cost
100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Clinics of Kentucky LLC CurrentSince Dec 1, 2004 Accepting new patients
United Clinics of Kentucky LLC Current Accepting new patients
United Clinics of Kentucky LLC CurrentSince Dec 1, 2004 Accepting new patients

Locations

151 N Eagle Creek Dr
Ste 310
Lexington, KY 40509
Phone (859) 263-0329

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1003843145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 MT PARKWAY SPUR",
            "city": "CAMPTON",
            "state": "KY",
            "postal_code": "41301",
            "telephone_number": "606-668-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 BROADWAY ST STE B",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017105",
            "telephone_number": "270-444-8183",
            "fax_number": "270-444-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "REAGAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95005468",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000388604",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.