Individual provider Active NPI

Vratislav V Kejzlar, MD

  • Anesthesiology Physician
  • Paducah, KY
National Provider Identifier
1023100849
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
23680 Issued in KY
Practice address
2725 James Sanders Blvd
Suite a
Paducah, KY 42001-8405
Phone
(270) 554-5114
Fax
(270) 554-5021
NPI assigned
Sep 29, 2006
Last updated
Sep 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 23680 KY Primary

Addresses

Primary practice location

2725 James Sanders Blvd
Suite a
Paducah, KY 42001-8405

Mailing address

2725 James Sanders Blvd
Suite a
Paducah, KY 42001-8405
Phone (270) 554-5114

Other identifiers 1

IdentifierTypeStateIssuer
64236805MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23680KYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Purchase Pain Managment LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1023100849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 JAMES SANDERS BLVD",
            "address_2": "SUITE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420018405",
            "telephone_number": "270-554-5114",
            "fax_number": "270-554-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 JAMES SANDERS BLVD",
            "address_2": "SUITE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420018405",
            "telephone_number": "270-554-5114",
            "fax_number": "270-554-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEJZLAR",
        "first_name": "VRATISLAV",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "23680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64236805",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.