NPIMap

Organization Active NPI

Clark Regional Physician Practices LLC

Doing business as Winchester General Surgery

  • Surgery Physician
  • Winchester, KY
National Provider Identifier
1073864559
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CLARK REGIONAL PHYSICIAN PRACTICES LLC
Doing business as
Winchester General Surgery
Practice address
225 Hospital Drive Suite 200B
Winchester, KY 40391-1158
Phone
(859) 737-9900
NPI assigned
Sep 25, 2012
Last updated
Sep 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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

Authorized official

Name
Sara Miller
Title
Director
Phone
(615) 202-9581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

225 Hospital Drive Suite 200B
Winchester, KY 40391-1158

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7905

Other names 1

  • Winchester General Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120919000575 KY Part B Supplier - Clinic/Group Practice 9739337569 Receives reassigned benefits from 102 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winchester, KY; Georgetown, KY; Lexington, KY; Mt Sterling, KY; Paris, KY; Stanton, KY

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

225 Hospital Dr
Ste 200B
Winchester, KY 40391
Phone (859) 737-6488

NPI Registry JSON

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506470400000",
    "number": "1073864559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7905",
            "fax_number": "615-920-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 HOSPITAL DRIVE SUITE 200B",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911158",
            "telephone_number": "859-737-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK REGIONAL PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-25",
        "last_updated": "2017-09-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-202-9581"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winchester General Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.