Kentucky Breast Care

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

KENTUCKY BREAST CARE

Practice address

38 Joe T Petty Drive
Russell Springs, KY 42642-8553

Phone

(606) 658-9535

Fax

(270) 866-9716

NPI assigned

Jun 14, 2012

Last updated

Nov 2, 2012By 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

Andrea Woodroof, M.D.

Title

Managing Member

Phone

(606) 658-9535

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ei-kbc

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dawn Andrea Woodroof, MD

  • Diagnostic Radiology Physician
  • Russell Springs, KY
  • NPI 1417145392
  Medicare reassignment NPD

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1295097319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 JOE T PETTEY DRIVE",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426428553",
            "telephone_number": "606-658-9535",
            "fax_number": "270-866-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 JOE T PETTY DRIVE",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426428553",
            "telephone_number": "606-658-9535",
            "fax_number": "270-866-9716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY BREAST CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "WOODROOF",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "606-658-9535",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100212880",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dalene Joy Jones, MAMFC, PLPC, MFTA
• Madyson Jones
• Taylor Jones, APRN
• Erika W Kelly, DO
• Taylor Keltner, LPCC
• Kid Steps Inc
• Della M Kincaid, RN
• Alisha A Knight, APRN
• Kroger Limited Partnership I (Kroger Pharmacy)
• Lake Cumberland Area Development District

• Diagnostic Radiology Physician in Russell Springs, KY
• Providers in Russell Springs, KY by specialty
• Diagnostic Radiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.