Paige Primary Care Center

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PAIGE PRIMARY CARE CENTER

Practice address

1023 New Moody LN
Suite 201
La Grange, KY 40031-9177

Phone

(502) 225-4480

Fax

(502) 225-9169

NPI assigned

May 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Carlton Damon Paige, M.D.

Title

President

Phone

(502) 225-4480

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Carl D. Paige, MD, PSC Former legal business name

Locations

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390521600000",
    "number": "1144270018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 NEW MOODY LN",
            "address_2": "SUITE 201",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319177",
            "telephone_number": "502-225-4480",
            "fax_number": "502-225-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 NEW MOODY LN",
            "address_2": "SUITE 201",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319177",
            "telephone_number": "502-225-4480",
            "fax_number": "502-225-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIGE PRIMARY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2014-01-24",
        "status": "A",
        "authorized_official_last_name": "PAIGE",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_middle_name": "DAMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-225-4480",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "41864",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "D0433",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100169030",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carl D. Paige, MD, PSC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Amanda Orr, LPCC
• Marykate Orr, BS,IECE
• Bruce Willard Osborne Jr., LPC
• Donna Jane Owens
• Kaitlyn Page
• Jessica Ann Parrett
• Rameshbhai Patel, M.D.
• Clayton Patross
• Lynda Denise Payne-Stikes, MS, CCC-SLP
• Pediatric Dentistry of Oldham Countyq

• Pediatrics Physician in La Grange, KY
• Providers in La Grange, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.