Individual provider Active NPI

Colby Joeann Dupin, PA

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1194516179
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC080 Issued in KY
Practice address
740 S Limestone Ste L119
Lexington, KY 40536-7001
Phone
(859) 257-3253
Fax
(859) 323-1203
NPI assigned
May 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X TC080 KY
Surgical Physician Assistant 363AS0400X TC080 KY
Physician Assistant 363A00000X TC080 KY Primary

Addresses

Primary practice location

740 S Limestone Ste L119
Lexington, KY 40536-7001

Mailing address

800 Rose St
Lexington, KY 40536-7001

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251024001323 KY Practitioner - Physician Assistant 8224526801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians
University of KentuckyGroup PAC ID 3072425289, 778 clinicians

Practice addresses (Care Compare)

1140 Lexington Rd
Georgetown, KY 40324-9330
Phone (502) 868-1100

740 S Limestone St
Lexington, KY 40508-0001
Phone (859) 233-5950

Hospital & facility affiliations

  • Clark Regional Medical Center Hospital, Winchester, KY, CCN 180092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TC080KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Oct 10, 2025 Accepting new patients
Southeastern Emergency Physicians LLC Physician Assistant CurrentSince Feb 1, 2026 Accepting new patients

Locations

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

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

175 Hospital Dr
Winchester, KY 40391
Phone (859) 745-3500

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1194516179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405367001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE L119",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405367001",
            "telephone_number": "859-257-3253",
            "fax_number": "859-323-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPIN",
        "first_name": "COLBY",
        "middle_name": "JOEANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-16",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "TC080",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "TC080",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.