Individual provider Active NPI

Cheryl D Hancock, KCSA

  • Surgical Technologist
  • Madisonville, KY
National Provider Identifier
1194804138
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
License
SA076 Issued in KY
Practice address
200 Clinic Dr
Madisonville, KY 42431-1661
Phone
(270) 825-7200
NPI assigned
Nov 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X SA076 KY Primary

Addresses

Primary practice location

200 Clinic Dr
Madisonville, KY 42431-1661

Mailing address

200 Clinic Dr
Madisonville, KY 42431-1661
Phone (270) 825-7200

Other identifiers 1

IdentifierTypeStateIssuer
SA076OtherKYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA076KYMDSurgical Technologist

Interoperability endpoints

  • Direct secure messaging: chancock46986@bhkydirect.com

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194804138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-825-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-825-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "CHERYL",
        "middle_name": "D",
        "credential": "KCSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "KY",
            "license": "SA076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "SA076",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.