Organization Active NPI

Bluegrass Medical Group PSC

  • Family Medicine Physician
  • Lexington, KY
National Provider Identifier
1164518130
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 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
Last updated
Dec 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Authorized official

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 25337 KY
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 26673 KY
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 41917 KY
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Family Health Clinical Nurse SpecialistGroup: 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

National Provider Directory

National Provider Directory

Locations

1401 Harrodsburg Rd
Ste C305
Lexington, KY 40504
Phone (859) 278-8400

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1164518130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 HARRODSBURG RD",
            "address_2": "SUITE D 502",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043758",
            "telephone_number": "859-277-8560",
            "fax_number": "859-277-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 HARRODSBURG RD",
            "address_2": "SUITE D 502",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043758",
            "telephone_number": "859-277-8560",
            "fax_number": "859-277-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS MEDICAL GROUP PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "859-277-8560",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "25337",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "26673",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "41917",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "KY",
            "license": "3005655",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.