Bluegrass Medical Group PSC

Organization Active NPI Family Medicine Physician · Lexington, KY

NPI 1164518130 · NPPES record last updated Dec 18, 2014

Key facts

NPI
1164518130
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
BLUEGRASS MEDICAL GROUP PSC
Practice address
1451 Harrodsburg Rd
Suite D 502
Lexington, KY 40504-3758
Phone
(859) 277-8560
Fax
(859) 277-8866
NPI assigned
Oct 5, 2006
Organization subpart
No

Authorized official

Name
Mrs. Dana Rae Barry
Title
Practice Manager
Phone
(859) 277-8560

Practitioners 4

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

National Provider Directory

Locations

1451 Harrodsburg Rd
Ste D502
Lexington, KY 40504
Phone (859) 277-8560

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist
Group: 193200000X MULTI-SPECIALTY GROUP
174400000X 25337 KY
Specialist
Group: 193200000X MULTI-SPECIALTY GROUP
174400000X 26673 KY
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 41917 KY
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X
Family Health Clinical Nurse Specialist
Group: 193200000X MULTI-SPECIALTY GROUP
364SF0001X 3005655 KY

Addresses

Primary practice location

1451 Harrodsburg Rd
Suite D 502
Lexington, KY 40504-3758

Mailing address

1451 Harrodsburg Rd
Suite D 502
Lexington, KY 40504-3758
Phone (859) 277-8560

Other identifiers

IdentifierTypeStateIssuer
000000055841OtherKYANTHEM
64253370MedicaidKY
65905234MedicaidKY

Other providers in Lexington, KY

All providers in Lexington, KY · Family Medicine Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.