Kentucky Gastroenterology PSC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

KENTUCKY GASTROENTEROLOGY PSC

Practice address

793 Eastern Byp
Suite 216
Richmond, KY 40475-2422

Phone

(859) 625-0900

Fax

(859) 625-0995

NPI assigned

Aug 4, 2008

Organization subpart

No

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

Authorized official

Name

Nadeem A Khan, MD

Title

Owner

Phone

(859) 625-0900

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1093971541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 EASTERN BYP",
            "address_2": "SUITE 216",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752422",
            "telephone_number": "859-625-0900",
            "fax_number": "859-625-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 EASTERN BYP",
            "address_2": "SUITE 216",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752422",
            "telephone_number": "859-625-0900",
            "fax_number": "859-625-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY GASTROENTEROLOGY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "NADEEM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-625-0900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000579699",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64333818",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Richmond, KY
• Gastroenterology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.