Active NPI
Varkey M Chacko, MD
- Surgery Physician
- Hazard, KY
National Provider Identifier
1285626879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 30438
- Practice address
- 200 Medical Center Dr
Hazard, KY 41701-9466 - Phone
- (606) 439-6801
- Fax
- (606) 439-6879
- NPI assigned
- Aug 18, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 30438 | KY | Primary |
Addresses
Primary practice location
200 Medical Center Dr
Hazard, KY 41701-9466
Mailing address
100 Airport Gardens Rd
Hazard, KY 41701-9529
Phone (606) 439-6900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64304389 | 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 |
|---|---|---|---|
| 30438 | KY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Lady of the Way Hospital, Inc | 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.
-
- Family Medicine Physician
- Martin, KY
- NPI 1255357364
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1285626879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 AIRPORT GARDENS RD",
"city": "HAZARD",
"state": "KY",
"postal_code": "417019529",
"telephone_number": "606-439-6900",
"fax_number": "606-439-6953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL CENTER DR",
"city": "HAZARD",
"state": "KY",
"postal_code": "417019466",
"telephone_number": "606-439-6801",
"fax_number": "606-439-6879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACKO",
"first_name": "VARKEY",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "30438",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64304389",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hazard, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.