Individual provider Active NPI

Raymond Wechman Jr., MD

  • Family Medicine Physician
  • Georgetown, KY
National Provider Identifier
1063497113
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25343 Issued in KY
Practice address
1138 Lexington Rd
Ste 130
Georgetown, KY 40324-9672
Phone
(502) 867-0222
Fax
(502) 867-0420
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25343 KY Primary

Addresses

Primary practice location

1138 Lexington Rd
Ste 130
Georgetown, KY 40324-9672

Mailing address

1138 Lexington Rd
Ste 130
Georgetown, KY 40324-9672
Phone (502) 867-0222

Other identifiers 1

IdentifierTypeStateIssuer
64253438MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050915000652 KY Practitioner - Family Practice 5698748689 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25343KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Mso LLC Current Accepting new patients
Kentucky Mso, LLC Family Medicine CurrentSince Feb 27, 2012 Accepting new patients
Kentucky Mso LLC CurrentSince Feb 27, 2012 Accepting new patients
Georgetown Family Physicians, PSC Family Medicine PastSince Aug 17, 2004 Accepting new patients
Marshall Emergency Services Associates, PLLC Past Accepting new patients

Locations

1502 Oxford Dr
Ste 100
Georgetown, KY 40324
Phone (502) 570-3785

1138 Lexington Rd
Ste 130
Georgetown, KY 40324
Phone (502) 570-2324

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

1140 Lexington Rd
Ste 105
Georgetown, KY 40324
Phone (502) 868-5660

Interoperability endpoints

  • Direct secure messaging: raymond.wechman.1@19475.direct.athenahealth.com
  • Direct secure messaging: igs8912@yourcarecommunity.org

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1063497113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 LEXINGTON RD",
            "address_2": "STE 130",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249672",
            "telephone_number": "502-867-0222",
            "fax_number": "502-867-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 LEXINGTON RD",
            "address_2": "STE 130",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249672",
            "telephone_number": "502-867-0222",
            "fax_number": "502-867-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WECHMAN",
        "first_name": "RAYMOND",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "25343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64253438",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.