Individual provider Active NPI

Jonathan Michael Feddock, MD

  • Radiation Oncology Physician
  • Lexington, KY
National Provider Identifier
1164685012
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
R1669 Issued in KY
Practice address
800 Rose Street HQ-101
Lexington, KY 40536-0293
Phone
(859) 229-2726
NPI assigned
Jul 9, 2008
Last updated
Jul 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X R1669 KY Primary

Addresses

Primary practice location

800 Rose Street HQ-101
Lexington, KY 40536-0293

Mailing address

4560 Windstar Way
Lexington, KY 40515-4818
Phone (859) 229-2726

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130209000030 KY Practitioner - Radiation Oncology 8729232202 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Kentucky College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Radiation Oncology of Lexington, PSCGroup PAC ID 7416907175, 7 clinicians

Practice addresses (Care Compare)

1700 Nicholasville Rd
Lexington, KY 40503-1463
Phone (859) 260-6460

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1669KYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2022 Accepting new patients
Radiation Oncology of Lexington, PSC Radiation Oncology CurrentSince May 1, 2018 Accepting new patients
Kentucky Medical Services Foundation, Inc Radiation Oncology CurrentSince Dec 17, 2012 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Mar 1, 2023 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2022 Accepting new patients

Locations

3615 E John Rowan Blvd
Ste 104
Bardstown, KY 40004
Phone (502) 331-4734

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

96 Future Dr
Corbin, KY 40701

1700 Nicholasville Rd
Lexington, KY 40503
Phone (859) 260-6100

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

800 Rose St
#101
Lexington, KY 40536
Phone (859) 323-5871

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

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 4

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1164685012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 WINDSTAR WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405154818",
            "telephone_number": "859-229-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE STREET HQ-101",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360293",
            "telephone_number": "859-229-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDDOCK",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "KY",
            "license": "R1669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.