Active NPI
Sleep Source Inc
- Durable Medical Equipment & Medical Supplies
- Paducah, KY
National Provider Identifier
1265442768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- SLEEP SOURCE INC
- Practice address
- 3121 Parisa Dr
Paducah, KY 42003-4584 - Phone
- (270) 575-0080
- Fax
- (270) 575-0081
- NPI assigned
- Aug 8, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. William Hogancamp, M.D.
- Title
- Co-Owner
- Phone
- (270) 575-0080
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Disorder Diagnostic Clinic/Center | 261QS1200X | 0700016509 | KY | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
3121 Parisa Dr
Paducah, KY 42003-4584
Mailing address
3121 Parisa Dr
Paducah, KY 42003-4584
Phone (270) 575-0080
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65940736 | Medicaid | KY | |
| 9372501 | Other | KY | MEDICARE PROVIDER # |
| 000000324218 | Other | KY | ANTHEM BC/BS # |
| 90011586 | Other | KY | MEDICAID DME |
| P00168379 | Other | KY | RR MEDICARE # |
National Provider Directory
National Provider DirectoryLocations
3121 Parisa Dr
Paducah, KY 42003
Phone (270) 575-0080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1248998400000",
"number": "1265442768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3121 PARISA DR",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420034584",
"telephone_number": "270-575-0080",
"fax_number": "270-575-0081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3121 PARISA DR",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420034584",
"telephone_number": "270-575-0080",
"fax_number": "270-575-0081"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SLEEP SOURCE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-08",
"last_updated": "2009-07-31",
"status": "A",
"authorized_official_last_name": "HOGANCAMP",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "CO-OWNER",
"authorized_official_telephone_number": "270-575-0080",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QS1200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Sleep Disorder Diagnostic",
"state": "KY",
"license": "0700016509",
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "65940736",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER #",
"identifier": "9372501",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS #",
"identifier": "000000324218",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DME",
"identifier": "90011586",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE #",
"identifier": "P00168379",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.