Individual provider Active NPI

George R Valentini, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Hopkinsville, KY
National Provider Identifier
1174704829
Registry record updated Jun 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
27209 Issued in KY
Practice address
1724 Kenton St
Suite 1C
Hopkinsville, KY 42240-1981
Phone
(270) 885-1140
Fax
(270) 885-1183
NPI assigned
Nov 23, 2007
Last updated
Jun 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 27209 KY Primary

Addresses

Primary practice location

1724 Kenton St
Suite 1C
Hopkinsville, KY 42240-1981

Mailing address

PO Box 4025
Hopkinsville, KY 42241-4025
Phone (270) 885-1140

Other identifiers 1

IdentifierTypeStateIssuer
64272099MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20180827003778 TN Practitioner - General Surgery 5799754834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healogics Specialty Physicians of Tennessee, PLLCGroup PAC ID 2961720313, 13 clinicians

Practice addresses (Care Compare)

651 Dunlop LN
Clarksville, TN 37040-5015
Phone (931) 502-3660

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1105
Removal of skin lesions34
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27209KYMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Tennessee, PLLC CurrentSince Jun 13, 2018 Accepting new patients

Locations

647 Dunlop Ln
Ste 108
Clarksville, TN 37040
Phone (904) 446-3400

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000

Interoperability endpoints

  • Direct secure messaging: gvalentini@direct-address.org

Organizations & group practices 2

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 5

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": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213401600000",
    "number": "1174704829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4025",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422414025",
            "telephone_number": "270-885-1140",
            "fax_number": "270-885-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 KENTON ST",
            "address_2": "SUITE 1C",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401981",
            "telephone_number": "270-885-1140",
            "fax_number": "270-885-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTINI",
        "first_name": "GEORGE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-23",
        "last_updated": "2008-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "KY",
            "license": "27209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64272099",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

Verify at the official NPI Registry.