Individual provider Active NPI

Lyndsay Collette, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1265960504
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA229 Issued in KY
Practice address
1221 S Broadway
Lexington, KY 40504-2701
Phone
(859) 258-6200
NPI assigned
May 31, 2017
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC590 KY
Physician Assistant 363A00000X PA229 KY Primary

Addresses

Primary practice location

1221 S Broadway
Lexington, KY 40504-2701

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200

Other practice location 1

803 Meyers Baker Rd Ste 200
London, KY 40741-3040
Phone (606) 878-3240

Other identifiers 1

IdentifierTypeStateIssuer
7100462680MedicaidKY

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170622002511 KY Practitioner - Physician Assistant 3971871534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1019 Cumberland Falls Hwy
Suite D141
Corbin, KY 40701-2796
Phone (606) 528-5527

313 S Cherry St
Pineville, KY 40977-1724
Phone (606) 654-3338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA229KYMDPhysician Assistant
TC590KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Community Health Center, Inc. CurrentSince Oct 21, 2024 Accepting new patients

Locations

1019 Cumberland Falls Hwy
Ste B201
Corbin, KY 40701

1019 Cumberland Falls Hwy
Ste D141
Corbin, KY 40701
Phone (606) 528-5527

313 S Cherry St
Pineville, KY 40977
Phone (606) 654-3338

Interoperability endpoints

  • Direct secure messaging: lcollette342933@direct.stlukeshealth.org
  • Direct secure messaging: lcollette759463@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1265960504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803 Meyers Baker Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "London",
            "state": "KY",
            "postal_code": "407413040",
            "country_code": "US",
            "telephone_number": "606-878-3240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLETTE",
        "first_name": "LYNDSAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC590",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100462680",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.