Commonwealth Gastroenterology Associates, PLLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

COMMONWEALTH GASTROENTEROLOGY ASSOCIATES, PLLC

Practice address

177 Burt Rd
Burt Road Medical Clinic
Lexington, KY 40503-2410

Phone

(859) 967-2055

Fax

(859) 278-8488

NPI assigned

Nov 15, 2006

Last updated

May 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bryan Keller Stadig, MBA, CMPE

Title

Administrator

Phone

(859) 967-2055

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1285707885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 BURT RD",
            "address_2": "BURT ROAD MEDICAL CLINIC",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032410",
            "telephone_number": "859-967-2055",
            "fax_number": "859-278-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 BURT RD",
            "address_2": "BURT ROAD MEDICAL CLINIC",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032410",
            "telephone_number": "859-967-2055",
            "fax_number": "859-278-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH GASTROENTEROLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "STADIG",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "KELLER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "859-967-2055",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, CMPE"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65930695",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Commonwealth Anesthesia, PSC
• Commonwealth Dermatology PSC
• Commonwealth Eye Clinic Inc
• Commonwealth Family Clinic, PLLC
• Commonwealth Family Physicians PSC
• Commonwealth Hand Therapy
• Commonwealth Hand Therapy
• Commonwealth Integrity Pain Center PLLC
• Commonwealth Medical Care, LLC
• Commonwealth Medical Partners Inc (Commonwealth Medical Partners)

• Gastroenterology Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Gastroenterology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.