NPIMap

Organization Active NPI

Concentra Primary Care PA

  • Primary Care Clinic/Center
  • Nicholasville, KY
National Provider Identifier
1134476203
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CONCENTRA PRIMARY CARE PA
Practice address
204 Bellaire Drive
Nicholasville, KY 40356-8840
Phone
(859) 887-4882
Fax
(859) 881-1728
NPI assigned
Aug 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Authorized official

Name
Dr. Robert Hassett, DO
Title
President / Treasurer
Phone
(972) 364-8000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Primary Care Clinic/Center 261QP2300X Primary
Medical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AM0700X
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

204 Bellaire Drive
Nicholasville, KY 40356-8840

Mailing address

5080 Spectrum Drive
Suite 1200 West
Addison, TX 75001-4648
Phone (972) 720-7772

Other names 1

  • Concentra Primary Care Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2053148Concentra Primary Care - Nicholasville204 Bellaire Drive, Nicholasville, KY 40356Certificate of waiverMar 9, 2028

National Provider Directory

National Provider Directory
Tax ID family
Concentra Primary Care44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1134476203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DRIVE",
            "address_2": "SUITE 1200 WEST",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "972-720-7772",
            "fax_number": "214-775-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 BELLAIRE DRIVE",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403568840",
            "telephone_number": "859-887-4882",
            "fax_number": "859-881-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCENTRA PRIMARY CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "HASSETT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT / TREASURER",
        "authorized_official_telephone_number": "972-364-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concentra Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nicholasville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.