Active NPI
Kentucky Hospital, LLC
- Clinical Medical Laboratory
- Winchester, KY
National Provider Identifier
1275790230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- KENTUCKY HOSPITAL, LLC
- Practice address
- 1107 W Lexington Ave
Winchester, KY 40391-1169 - Phone
- (859) 745-3500
- Fax
- (859) 745-3450
- NPI assigned
- May 19, 2008
- 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
- Mr. Robert Donald Fraraccio
- Title
- Chief Executive Officer
- Phone
- (859) 745-3500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | KY | Primary |
Addresses
Primary practice location
1107 W Lexington Ave
Winchester, KY 40391-1169
Mailing address
1107 W Lexington Ave
Winchester, KY 40391-1169
Phone (859) 745-3500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000061940 | Other | KY | ANTHEM BLUE CROSS BLUE SHIELD |
| 000000657636 | Other | KY | ANTHEM BLUE CROSS BLUE SHEILD REFERENCE LAB |
Other names 1
- Clark Regional Medical Center
National Provider Directory
National Provider Directory- Tax ID family
- Kentucky Hospital LLC
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatric Occupational Therapist
- Winchester, KY
- NPI 1245550813
-
- Clinic/Center
- Winchester, KY
- NPI 1356668057
-
- General Acute Care Hospital
- Winchester, KY
- NPI 1811213994
Locations
1107 W Lexington Ave
Winchester, KY 40391
Phone (859) 745-3500
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1274832000000",
"number": "1275790230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 W LEXINGTON AVE",
"city": "WINCHESTER",
"state": "KY",
"postal_code": "403911169",
"telephone_number": "859-745-3500",
"fax_number": "859-745-3450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 W LEXINGTON AVE",
"city": "WINCHESTER",
"state": "KY",
"postal_code": "403911169",
"telephone_number": "859-745-3500",
"fax_number": "859-745-3450"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENTUCKY HOSPITAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-19",
"last_updated": "2010-05-26",
"status": "A",
"authorized_official_last_name": "FRARACCIO",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "DONALD",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "859-745-3500",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "KY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
"identifier": "000000061940",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SHEILD REFERENCE LAB",
"identifier": "000000657636",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Clark Regional Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}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 May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.