NPIMap

Organization Active NPI

Tri State Nephrology PSC

  • Nurse Practitioner
  • Ashland, KY
National Provider Identifier
1215085170
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4797P Issued in KY
Legal business name
TRI STATE NEPHROLOGY PSC
Practice address
432 16TH St
Suite B
Ashland, KY 41101-7693
Phone
(606) 329-9335
Fax
(606) 324-6383
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Donald N Hammonds Jr., DONPI 1235123621
Title
President
Phone
(606) 329-9335

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
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 4797P KY Primary

Addresses

Primary practice location

432 16TH St
Suite B
Ashland, KY 41101-7693

Mailing address

PO Box 2468
Ashland, KY 41105-2468
Phone (606) 329-9335

Other identifiers 1

IdentifierTypeStateIssuer
78902582MedicaidKY

Other names 1

  • TRI STATE NEPHROLOGY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1215085170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2468",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052468",
            "telephone_number": "606-329-9335",
            "fax_number": "606-324-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 16TH ST",
            "address_2": "SUITE B",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017693",
            "telephone_number": "606-329-9335",
            "fax_number": "606-324-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE NEPHROLOGY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "HAMMONDS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-329-9335",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4797P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78902582",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRI STATE NEPHROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.