Danville Medical Practice PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DANVILLE MEDICAL PRACTICE PLLC

Practice address

416A W Walnut St
Danville, KY 40422

Phone

(859) 936-2020

Fax

(859) 936-7424

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kathy D Bourne

Title

Office Manager

Phone

(859) 936-2020

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1043318561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416A W WALNUT ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "40422",
            "telephone_number": "859-936-2020",
            "fax_number": "859-936-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416A W WALNUT ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "40422",
            "telephone_number": "859-936-2020",
            "fax_number": "859-936-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE MEDICAL PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "BOURNE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "859-936-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB4203",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GROUP #",
            "identifier": "000000313483",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65940082",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Danville, KY
• Providers in Danville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.