NPIMap

Organization Active NPI

Park Street Partners, L.L.P.

  • Family Medicine Physician
  • Bowling Green, KY
National Provider Identifier
1053341339
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PARK STREET PARTNERS, L.L.P.
Doing business as
URGENTCARE
Practice address
1225 Fairway St
Bowling Green, KY 42103-2477
Phone
(270) 781-3910
Fax
(270) 842-7177
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Authorized official

Name
Ronald G. Sowell
Title
Executive Vice President
Phone
(270) 745-1536

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1225 Fairway St
Bowling Green, KY 42103-2477

Mailing address

PO Box 3240
Bowling Green, KY 42102-3240
Phone (270) 745-1100

Other identifiers 2

IdentifierTypeStateIssuer
65900813MedicaidKY
78900982MedicaidKY

Other names 1

  • URGENTCARE Doing business as

National Provider Directory

National Provider Directory

Locations

1225 Fairway St
Bowling Green, KY 42103
Phone (270) 781-3910

Practitioners & affiliated clinicians

Practitioners 10

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": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1053341339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3240",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421023240",
            "telephone_number": "270-745-1100",
            "fax_number": "270-745-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 FAIRWAY ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421032477",
            "telephone_number": "270-781-3910",
            "fax_number": "270-842-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK STREET PARTNERS, L.L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "SOWELL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "270-745-1536"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65900813",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78900982",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "URGENTCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.