Kevin D Slentz, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

47235 Issued in KY

Practice address

429 W Walnut St
Lebanon, KY 40033-1346

Phone

(502) 868-5617

Fax

(502) 570-5610

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Athens Medical Group LLC

  • Family Medicine Physician
  • Crawfordsville, IN
  • NPI 1043444714

  Surgery

  NPD (past)
• Athens Medical Group, Inc

  • Family Medicine Physician
  • Crawfordsville, IN
  • NPI 1831205210

  Surgery

  NPD (past)
• Tribbett Family Medicine, LLC

  • Family Medicine Physician
  • Monticello, IN
  • NPI 1427416361
  NPD (past)

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1215991443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 W WALNUT ST",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331346",
            "telephone_number": "502-868-5617",
            "fax_number": "502-570-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 W WALNUT ST",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331346",
            "telephone_number": "502-868-5617",
            "fax_number": "502-570-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLENTZ",
        "first_name": "KEVIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01045043A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME109212",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "47235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003826400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200092810",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LICENSE",
            "identifier": "ME109212",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebekah Ann Sidebottom
• Jennifer Sievert, ARNP
• Mary Harriet Simms-Boone, LCSW
• Tessa Rae Simpson
• Michelle Lynn Slaughter
• Christopher Smith, DPT
• James M. Smith, M.D.
• Melissa Gail Smith, IECE
• Pamela Anne Smith, LCSW
• Robert Henry Smith, D.M.D.

• Surgery Physician in Lebanon, KY
• Providers in Lebanon, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.