NPIMap

Organization Active NPI

PJ Persson, PSC

  • Surgery Physician
  • Lebanon, KY
National Provider Identifier
1023376456
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
43219 Issued in KY
Legal business name
PJ PERSSON, PSC
Practice address
312 W High St
Lebanon, KY 40033-1428
Phone
(270) 692-9559
Fax
(270) 692-9236
NPI assigned
Apr 23, 2012
Last updated
Apr 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Authorized official

Name
Perjohan Persson, MDNPI 1912236902
Title
Owner
Phone
(859) 940-0146

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 43219 KY Primary

Addresses

Primary practice location

312 W High St
Lebanon, KY 40033-1428

Mailing address

602 Golfview Ter
Lebanon, KY 40033-1947
Phone (270) 692-9559

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1023376456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 GOLFVIEW TER",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331947",
            "telephone_number": "270-692-9559",
            "fax_number": "270-692-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W HIGH ST",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331428",
            "telephone_number": "270-692-9559",
            "fax_number": "270-692-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PJ PERSSON, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "PERSSON",
        "authorized_official_first_name": "PERJOHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-940-0146",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "KY",
            "license": "43219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.