Active NPI
Robert Russell Dennison Jr., MD
- Emergency Medicine Physician
- Winchester, KY
National Provider Identifier
1245394246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD16062
- Practice address
- 108 Hidden Grove LN
Winchester, KY 40391-8845 - Phone
- (859) 527-6601
- NPI assigned
- Dec 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD16062 | KY | Primary |
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | 16062 | KY |
Addresses
Primary practice location
108 Hidden Grove LN
Winchester, KY 40391-8845
Mailing address
3439 Buckhorn Drive
Suite 160
Lexington, KY 40515
Phone (859) 368-8820
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | KY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD16062 | KY | MD | Emergency Medicine Physician |
| 16062 | KY | MD | Addiction Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acute Care Specialists, Inc. | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1447294640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435104000000",
"number": "1245394246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3439 BUCKHORN DRIVE",
"address_2": "SUITE 160",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "40515",
"telephone_number": "859-368-8820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 HIDDEN GROVE LN",
"city": "WINCHESTER",
"state": "KY",
"postal_code": "403918845",
"telephone_number": "859-527-6601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNISON",
"first_name": "ROBERT",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2015-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "MD16062",
"primary": true
},
{
"code": "207RA0401X",
"taxonomy_group": "",
"desc": "Internal Medicine, Addiction Medicine",
"state": "KY",
"license": "16062",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winchester, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.