NPIMap

Organization Active NPI

West Kentucky Gynecology Associates PLLC

  • Gynecology Physician
  • Paducah, KY
National Provider Identifier
1154486942
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
35692 Issued in KY
Legal business name
WEST KENTUCKY GYNECOLOGY ASSOCIATES PLLC
Practice address
423 South 28TH St
Suite a
Paducah, KY 42003-3865
Phone
(270) 442-7181
Fax
(270) 442-0113
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Authorized official

Name
Dr. Johnny W Bryant, MD
Title
Doctor
Phone
(270) 442-7181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 35692 KY Primary

Addresses

Primary practice location

423 South 28TH St
Suite a
Paducah, KY 42003-3865

Mailing address

423 South 28TH St
Suite a
Paducah, KY 42003-3865
Phone (270) 442-7181

Other identifiers 1

IdentifierTypeStateIssuer
64013931MedicaidKY

Other names 1

  • Gynecology Associates Former legal business name

National Provider Directory

National Provider Directory

Locations

423 S 28th St
Ste A
Paducah, KY 42003
Phone (270) 442-7181

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1154486942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 SOUTH 28TH ST",
            "address_2": "SUITE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033865",
            "telephone_number": "270-442-7181",
            "fax_number": "270-442-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 SOUTH 28TH ST",
            "address_2": "SUITE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033865",
            "telephone_number": "270-442-7181",
            "fax_number": "270-442-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST KENTUCKY GYNECOLOGY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "270-442-7181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "KY",
            "license": "35692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64013931",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gynecology Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.