NPIMap

Organization Active NPI

Pikeville Radiology

  • Diagnostic Radiology Physician
  • Pikeville, KY
National Provider Identifier
1104006113
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PIKEVILLE RADIOLOGY
Practice address
387 Town Mountain Rd
Suite 106
Pikeville, KY 41501-1640
Phone
(606) 432-9094
Fax
(606) 432-1832
NPI assigned
Nov 7, 2007
Last updated
Nov 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Dr. Alexander Poulos, M.D.
Title
Member
Phone
(606) 432-1357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

387 Town Mountain Rd
Suite 106
Pikeville, KY 41501-1640

Mailing address

PO Box 2648
Pikeville, KY 41502-2648
Phone (606) 432-1357

Other identifiers 2

IdentifierTypeStateIssuer
65932626MedicaidKY
0958131OtherKYUMWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1104006113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2648",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415022648",
            "telephone_number": "606-432-1357",
            "fax_number": "606-432-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 TOWN MOUNTAIN RD",
            "address_2": "SUITE 106",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011640",
            "telephone_number": "606-432-9094",
            "fax_number": "606-432-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKEVILLE RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "POULOS",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "606-432-1357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65932626",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "0958131",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.