Organization Active NPI

Slobodan B Jugo PSC

  • Otolaryngology Physician
  • Greenville, KY
National Provider Identifier
1184814162
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
SLOBODAN B JUGO PSC
Practice address
300 Medical PLZ
Greenville, KY 42345-1220
Phone
(270) 338-6650
Fax
(270) 338-6653
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Authorized official

Name
Dr. Slobodan B Jugo, M.D.NPI 1609978899
Title
Owner
Phone
(270) 338-6650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

300 Medical PLZ
Greenville, KY 42345-1220

Mailing address

300 Medical PLZ
Greenville, KY 42345-1220
Phone (270) 338-6650

Other identifiers 1

IdentifierTypeStateIssuer
64212129MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050510001021 KY Part B Supplier - Clinic/Group Practice 0143260042 Receives reassigned benefits from 1 practitioner
Practice locations: Greenville, KY

National Provider Directory

National Provider Directory

Locations

300 Medical Plz
Greenville, KY 42345
Phone (270) 338-6650

Practitioners & affiliated clinicians

Practitioners 1

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": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374105600000",
    "number": "1184814162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451220",
            "telephone_number": "270-338-6650",
            "fax_number": "270-338-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451220",
            "telephone_number": "270-338-6650",
            "fax_number": "270-338-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLOBODAN B JUGO PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2013-07-18",
        "status": "A",
        "authorized_official_last_name": "JUGO",
        "authorized_official_first_name": "SLOBODAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-338-6650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64212129",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.