Individual provider Active NPI

Evan Hunter Mussetter, M.D.

  • Emergency Medicine Physician
  • Ashland, KY
National Provider Identifier
1114242641
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
46512 Issued in KY
Practice address
1000 Saint Christopher Dr
Ashland, KY 41101-7034
Phone
(606) 833-3605
NPI assigned
Mar 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 46512 KY Primary

Addresses

Primary practice location

1000 Saint Christopher Dr
Ashland, KY 41101-7034

Mailing address

1000 Saint Christopher Dr
Ashland, KY 41101-7034
Phone (606) 833-3605

Other identifiers 1

IdentifierTypeStateIssuer
46512OtherKYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111025000398 KY Practitioner - Emergency Medicine 4981877693 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Louisville School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

710 N Carol Malone Boulevard
Suite a
Grayson, KY 41143-1126
Phone (606) 474-0157

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as virtual group
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46512KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Jan 15, 2017 Accepting new patients
West Fairview Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
University Medical Center, Inc Emergency Medicine Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1114242641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SAINT CHRISTOPHER DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017034",
            "telephone_number": "606-833-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SAINT CHRISTOPHER DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017034",
            "telephone_number": "606-833-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSETTER",
        "first_name": "EVAN",
        "middle_name": "HUNTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-26",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "46512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "46512",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.