Medical Investment Trust

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

17816 Issued in KY

Legal business name

MEDICAL INVESTMENT TRUST

Doing business as

Asthma and Allergy Center

Practice address

156 Island Creek Rd
Pikeville, KY 41501-9340

Phone

(606) 432-0174

Fax

(606) 437-0438

NPI assigned

Jan 31, 2006

Last updated

Sep 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Djien H So

Title

Administrator

Phone

(606) 432-0174

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Asthma and Allergy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Medical Investment Trus2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Asthma & Allergy Center

  • Allergy & Immunology Physician
  • Hazard, KY
  • NPI 1811153364
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Pediatric Associates

  dba Pediatric Associates of Hazard

  • Rural Health Clinic/Center
  • Hazard, KY
  • NPI 1487600615

  Member Of

  NPD member

Practitioners 4

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.

• Sarah Ann Coleman, APRN

  • Family Nurse Practitioner
  • Pikeville, KY
  • NPI 1467997940
  Medicare reassignment Care Compare group NPD
• Leonor S Pagtakhan So, MD

  • Allergy & Immunology Physician
  • Pikeville, KY
  • NPI 1376533091
  Medicare reassignment Care Compare group NPD
• Bernie Justice, ARNP

  • Family Nurse Practitioner
  • Pikeville, KY
  • NPI 1679702492
  Medicare reassignment NPD
• Thomas Que Lim Jr., MD

  • Nephrology Physician
  • Las Vegas, NV
  • NPI 1790775682
  NPD (past)

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1053382788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2708",
            "address_2": "ASTHMA AND ALLERGY CENTER",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415022708",
            "telephone_number": "606-432-0174",
            "fax_number": "606-437-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 ISLAND CREEK RD",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415019340",
            "telephone_number": "606-432-0174",
            "fax_number": "606-437-0438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1710 N Main St",
            "address_purpose": "LOCATION",
            "city": "Hazard",
            "state": "KY",
            "postal_code": "417011278",
            "country_code": "US",
            "telephone_number": "606-439-4865",
            "fax_number": "606-436-9953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL INVESTMENT TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "SO",
        "authorized_official_first_name": "DJIEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "606-432-0174"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "KY",
            "license": "17816",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3001627",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65-922866",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Asthma and Allergy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen McPeek
• Andrea Kneal Meade, BA
• James Meade, BA
• Vanessa Meade
• Brandy M Meadows, APRN
• Mercy Ambulance of Evansville Inc (American Medical Response; AMR; LIFEGUARD EMERGENCY MEDICAL SERVICES;)
• Elizabeth Ann Merlo, PHARM D
• Jyothi Mettu, M.D.
• Ramanarao V Mettu, MD
• Haitem Mezughi, M.D.

• Allergy & Immunology Physician in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Allergy & Immunology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.