NPIMap

Individual provider Active NPI

Henry R Preston, MD

  • Family Medicine Physician
  • Georgetown, KY
National Provider Identifier
1154306207
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31821 Issued in KY
Practice address
1138 Lexington Road Suite 130
Georgetown, KY 40324
Phone
(502) 867-0222
Fax
(502) 867-0420
NPI assigned
Dec 13, 2005
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31821 KY Primary
Sleep Medicine (Family Medicine) Physician 207QS1201X 31821 KY

Addresses

Primary practice location

1138 Lexington Road Suite 130
Georgetown, KY 40324

Mailing address

1138 Lexington Road Suite 130
Georgetown, KY 40324
Phone (502) 867-0222

Other identifiers 1

IdentifierTypeStateIssuer
64318215MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090115000785 KY Practitioner - Family Practice 4385707496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
JC Edwards School of Medicine, Marshall University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kentucky Mso LLCGroup PAC ID 0749450633, 53 clinicians

Practice addresses (Care Compare)

105 Prather Path
Georgetown, KY 40324-9206

175 Hospital Dr
Suite 120
Georgetown, KY 40324
Phone (502) 570-2324

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31821KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Mso LLC CurrentSince Feb 27, 2012 Accepting new patients
Bourbon Physician Practice LLC Current Accepting new patients
Kentucky Mso LLC CurrentSince Feb 27, 2012 Accepting new patients
Bourbon Physician Practice LLC CurrentSince Jul 1, 2013 Accepting new patients
Kentucky Mso LLC Past Accepting new patients
Bourbon Physician Practice LLC Family Medicine Past Accepting new patients

Locations

1138 Lexington Rd
Ste 130
Georgetown, KY 40324
Phone (502) 570-2324

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

1140 Lexington Rd
Ste 105
Georgetown, KY 40324
Phone (502) 868-5660

22 Clinic Dr
Paris, KY 40361
Phone (859) 987-0074

Interoperability endpoints

  • Direct secure messaging: henry.preston.1@19475.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19475/brand/10/csg/41/fhir/r4
  • Direct secure messaging: izl8717@yourcarecommunity.org

Organizations & group practices 6

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

Hospital & facility affiliations 6

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1154306207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 LEXINGTON ROAD SUITE 130",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "40324",
            "telephone_number": "502-867-0222",
            "fax_number": "502-867-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 LEXINGTON ROAD SUITE 130",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "40324",
            "telephone_number": "502-867-0222",
            "fax_number": "502-867-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "HENRY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "31821",
            "primary": true
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "KY",
            "license": "31821",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64318215",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.