Bhatraju Medical Clinic

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

PA953 Issued in KY

Legal business name

BHATRAJU MEDICAL CLINIC

Practice address

180 Town Mountain Rd
Suite 111
Pikeville, KY 41501-1698

Phone

(606) 432-0168

NPI assigned

Mar 23, 2009

Organization subpart

No

Name

Allen Maynard, PA-C

Title

PA-Manager

Phone

(606) 432-0168

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 23, 2009.

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1083855993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 TOWN MOUNTAIN RD",
            "address_2": "SUITE 111",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011698",
            "telephone_number": "606-432-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 TOWN MOUNTAIN RD",
            "address_2": "SUITE 111",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011698",
            "telephone_number": "606-432-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHATRAJU MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "MAYNARD",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "PA-MANAGER",
        "authorized_official_telephone_number": "606-432-0168",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "KY",
            "license": "PA953",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "KY",
            "license": "PA953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Lou Bevins, LPCC, LCADC
• Audra Bevins, RN
• Corie Lynn Bevins, APRN
• Jeremy Clarke Bevins, APRN
• Ravinder Singh Bhagrath, MD
• Rao S Bhatraju, M.D.
• BHG Lviii, LLC
• BHG Lviii, LLC
• BHG XXV, LLC
• Big Sandy Dental Center PSC

• All providers in Pikeville, KY
• Interventional Pain Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.