Charles G Ison

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

29376 Issued in KY

Practice address

3050 Harrodsburg Rd
Lexington, KY 40503-2747

Phone

(859) 277-6102

Fax

(859) 977-0237

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Pediatric Medicine

Education

University of Kentucky College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Lexington Clinic PSCGroup PAC ID 3476457532, 329 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.ison.1@13059.direct.athenahealth.com

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.

• New Lexington Clinic, PSC

  • Multi-Specialty Clinic/Center
  • Lexington, KY
  • NPI 1700803681
  Medicare reassignment Care Compare group NPD
• New Lexington Clinic PSC

  • Clinical Medical Laboratory
  • Lexington, KY
  • NPI 1285409425
  NPD
• Pediatric & Adolescent Associates

  • Pediatric Adolescent Medicine Physician
  • Lexington, KY
  • NPI 1952402091
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1144298993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 HARRODSBURG RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032747",
            "telephone_number": "859-277-6102",
            "fax_number": "859-977-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISON",
        "first_name": "CHARLES",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "29376",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "KY",
            "license": "29376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64293764",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammed Tashfiqul Islam, M.D.
• Alexandra Nicole Isler, APRN
• Roisin Mary Isley
• Bahaaeldeen Senousy Mohammed Ismail, M.D.
• Cayla Delynn Ison
• Lynda L Ison, PHD
• Keziah Israel, BA, RBT
• Mohamad Istanboli, MD
• Amanda Lee Istvan, MSW, CSW
• Misa Ito, MD PHD

• Pediatric Adolescent Medicine Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Pediatric Adolescent Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.