Individual provider Active NPI

Wayne D. Lay, D.M.D.

  • Dentist
  • Elizabethtown, KY
National Provider Identifier
1063597573
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5775 Issued in KY
Practice address
238 W Dixie Ave
Elizabethtown, KY 42701-1554
Phone
(270) 765-4162
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5775 KY Primary
Dentist 122300000X DN10093 FL

Addresses

Primary practice location

238 W Dixie Ave
Elizabethtown, KY 42701-1554

Mailing address

677 Timber LN
Elizabethtown, KY 42701-8907
Phone (270) 982-3811

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150429000186 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8426377219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN10093FLMDDentist
5775KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063597573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 TIMBER LN",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018907",
            "telephone_number": "270-982-3811",
            "fax_number": "270-982-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 W DIXIE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011554",
            "telephone_number": "270-765-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAY",
        "first_name": "WAYNE",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "5775",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN10093",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.