Individual provider Active NPI

John A Patterson, M.D.

  • Family Medicine Physician
  • Lexington, KY
National Provider Identifier
1235100876
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18031 Issued in KY
Practice address
740 S Limestone
K302 Kentucky Clinic
Lexington, KY 40536-0001
Phone
(859) 323-6711
Fax
(859) 323-6661
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18031 KY Primary

Addresses

Primary practice location

740 S Limestone
K302 Kentucky Clinic
Lexington, KY 40536-0001

Mailing address

740 S Limestone
K302 Kentucky Clinic
Lexington, KY 40536-0001
Phone (859) 323-6711

Other identifiers 1

IdentifierTypeStateIssuer
64108318MedicaidKY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000092 KY Practitioner - Family PracticePractitioner - Preventive Medicine 2466557749 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18031KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
One Cross Health Clinic Inc CurrentSince Aug 23, 2020 Accepting new patients
Kentucky Medical Services Foundation, Inc Family Medicine CurrentSince Jan 6, 2013 Accepting new patients
Riverview Clinic PSC Family Medicine PastSince Nov 1, 2000 Accepting new patients

Locations

102 Winston Way
Ste 5
Campbellsvlle, KY 42718
Phone (270) 789-0034

106 Winston Way
Campbellsvlle, KY 42718
Phone (270) 789-0034

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1235100876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "address_2": "K302 KENTUCKY CLINIC",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-6711",
            "fax_number": "859-323-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "address_2": "K302 KENTUCKY CLINIC",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-6711",
            "fax_number": "859-323-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "18031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64108318",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.