Healthsource of Southeast Lexington Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4578 Issued in KY

Legal business name

HEALTHSOURCE OF SOUTHEAST LEXINGTON INC.

Practice address

4101 Tates Creek Centre Dr
Suite 132
Lexington, KY 40517-3066

Phone

(859) 272-5460

Fax

(859) 272-5463

NPI assigned

Jul 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Michael Newell Pugh, D.C.NPI 1255365706

Title

Chiropractor

Phone

(859) 272-5460

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael N. Pugh, D.C.

  • Chiropractor
  • Lexington, KY
  • NPI 1255365706
  Medicare reassignment Authorized official
• Leighnia Tyrese Nance, RN

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1881066124
  Medicare reassignment NPD
• Joey Kyle Creekbaum III, APRN, FNP-BC

  • Family Nurse Practitioner
  • Lexington, KY
  • NPI 1639802515
  Medicare reassignment

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1104081306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TATES CREEK CENTRE DR",
            "address_2": "SUITE 132",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173066",
            "telephone_number": "859-272-5460",
            "fax_number": "859-272-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TATES CREEK CENTRE DR",
            "address_2": "SUITE 132",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173066",
            "telephone_number": "859-272-5460",
            "fax_number": "859-272-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF SOUTHEAST LEXINGTON INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "PUGH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "NEWELL",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "859-272-5460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Healthfirst Bluegrass Inc.
• Healthfirst Bluegrass, Inc
• Healthfirst Bluegrass, Inc
• Healthsure Medical Clinic PLLC
• James Heaphy, MD
• Brandon Hearld
• Heart Rescue CPR LLC
• Avery Heath

• Chiropractor in Lexington, KY
• Providers in Lexington, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.